Cadenelli Pierfrancesco, Fracon Stefano, Bordoni Daniele, Lalli Luca, Folli Secondo
Introduction: The most common surgical technique in implant-based breast reconstruction is the two-stage approach, positioning the expander in the submuscular plane. In our series, the inferolateral aspect of the implant was covered by the Serratus Anterior Muscle (SAM) or Serratus Anterior Fascia (SAF), preserving the muscle. The aim of this retrospective cohort study is to compare the two techniques in terms of morbidity, complications, and reconstructive outcome.
Materials And Methods: 196 women underwent mastectomy and immediate breast reconstruction for breast cancer referring to our center from 2017 to 2018 were enrolled in the study. Patients were divided into two groups, according to the technique used to cover the inferolateral aspect of the implant: 103 women were in the SAM group, and 83 in the SAF group.
Results: In SAM group, 3 women had postoperative bleeding, requiring surgery. In the SAF group, only 1 woman needed a surgical revision. Comparing the two techniques, length of hospitalization stays, and post-operative pain were statistically significantly lower in the SAF group than in the SAM group (p<0.05).
Conclusions: SAF flap could be considered a safe and effective technique compared to the use of SAM to cover the inferolateral part of the implant, allowing to achieve a good reconstructive outcome and a good quality of life. However, larger studies are needed to confirm our results.
Level III: Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.