A simple clinical assessment of breast animation deformity following direct-to-implant breast reconstruction

다국어 초록 (Multilingual Abstract)

Background A high incidence of breast animation deformity (BAD) has been reported followingimmediate breast reconstruction with subpectorally placed implants. The aim of thisstudy was to assess and compare the incidence of BAD in women who underwent either subpectoralor prepectoral immediate breast reconstruction. Therefore, we developed a gradingtool and tested its reproducibility in a clinical setting.
Methods Video recordings of 37 women who had undergone unilateral or bilateral immediatebreast reconstruction were evaluated by two consultant plastic surgeons. The degree ofBAD was assessed by our grading tool, named the Nipple, Surrounding Skin, Entire Breast(NSE) grading scale, which evaluates the degree of tissue distortion in three areas of thebreast. Blinded assessments were performed twice by each observer.
Results Eighteen patients were reconstructed with subpectoral implant placement and 19with prepectoral implant placement. Using the NSE grading scale, we found a significant differencein the degree of BAD between the groups, in favor of patients who underwent prepectoralimmediate breast reconstruction (0.2 vs. 4, P=0.000). Inter- and intraobserver agreementwas moderate (74%) to strong (88%).
Conclusions The incidence and severity of BAD was significantly lower in women reconstructedwith a prepectorally placed implant than in those who underwent subpectoral immediatebreast reconstruction. All patients reconstructed using the subpectoral techniquehad some degree of BAD. The inter- and intraobserver agreements were high when using theNSE grading scale, suggesting it is an easy-to-use, reproducible scale for assessing BAD inwomen who undergo immediate breast reconstruction.

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