Kiernan T and Martin L
Currently all suitable women who require mastectomy for Breast Cancer should be offered breast reconstruction either as an immediate or delayed procedure. Various forms of breast reconstruction are available but since the introduction of Acellular Dermal Matrixes (ADMs), implant based reconstruction has become more popular. Implant based reconstruction has the advantages of being a relatively short operation with minimal morbidity compared to myocutaneous flap based reconstructions. ADMs are thought to improve the cosmetic outcomes of implant based reconstructions by allowing a more natural breast mound to be created. They also provide a one stage procedure as opposed to expander based reconstructions that require several inflations in clinic and a second operation to exchange the expander to a silicone implant. Most studies on the use of ADMs have been focused on cosmesis and financial or logistical benefits. To date there have been no studies on whether the use of ADM has an effect on post operative physiotherapy requirements. This study assessed the number of physiotherapy sessions required for women, who had undergone expander or ADM assisted breast reconstruction, to regain full shoulder mobility. There was no significant difference between the two procedures for physiotherapy requirements, with greater significance on the type of concomitant axillary surgery performed.