No Differences in Surgical and Patient-Reported Outcomes among AlloDerm, SurgiMend, and Dermacell for Prepectoral Implant-Based Breast Reconstruction

Background: Prepectoral implant-based breast reconstruction (IBR) has become the standard of care for many reconstructive surgeons and is often supplemented with coverage using acellular dermal matrix (ADM). However, more clinical data examining the use of ADM in breast reconstruction are needed. The current study compares complications and patient-reported outcomes (PROs) among three different types of ADM used in IBR. Methods: The authors performed a retrospective review of consecutive patients who underwent immediate prepectoral IBR from January of 2018 through December of 2019. Surgical outcomes and PROs (using the BREAST-Q) were compared among the AlloDerm, SurgiMend, and Dermacell ADMs. Results: Overall, 557 breasts (383 patients) were included (78.6% AlloDerm, 14% SurgiMend, 7.4% Dermacell). Patients in the Dermacell group were older (P = 0.001) and more likely to have diabetes (P = 0.001) compared with AlloDerm and SurgiMend patients. Other patient characteristics were similar among the three groups. The overall complication rate was equivalent among the three ADM groups (AlloDerm 27% vs SurgiMend 33% vs Dermacell 39%; P = 0.209). Multivariable frailty models demonstrated that the type of ADM was not significantly associated with overall complications, infection, major complications, or device explantation. BREAST-Q satisfaction with breasts, psychosocial well-being, and sexual well-being were also similar among the three ADM groups (P = 0.109, P = 0.439, P = 0.152, respectively). Conclusions: Three of the most commonly used ADMs in the United States have similar surgical outcomes and PROs when used for prepectoral IBR. No significant differences in infection, overall complications, or device removal rates were identified among AlloDerm, SurgiMend, and Dermacell.