Background: This single-center prospective cohort study evaluated the clinical outcomes of thick acellular dermal matrix (ADM) for partial volume correction in breast reconstruction. Small-to-moderate volume deficits commonly occur after partial or total mastectomy in Asian women with relatively small breasts and may not justify additional major flap surgery. This study aimed to evaluate the safety and efficacy of thick ADM (≤5 mm) for intraoperative partial volume correction across oncoplastic and reconstructive settings.
Methods: Between July 2022 and June 2023, thick ADM was applied as a deep onlay beneath glandular reshaping flaps, rotation flaps, or latissimus dorsi (LD) flaps in 20 prospectively enrolled cases, while 124 cases without thick ADM (67 partial mastectomy, 57 total mastectomy) served as a reference cohort; clinical variables, complications up to 6 months, and patient-reported satisfaction using a modified KNU Breast-Q were analyzed using appropriate statistical tests.
Results: The thick ADM group more frequently underwent oncoplastic volume displacement or replacement and received postoperative radiotherapy. However, rates of seroma, hematoma, dehiscence, fat necrosis-like firmness, infection, and reoperation were comparable between groups. No reconstruction failures or implant removals occurred in the thick ADM cohort. Both groups reported high satisfaction across all domains.
Conclusions: Thick ADM is a safe, practical option for targeted partial volume correction following partial or total mastectomy, enabling restoration of contour and symmetry without increased short-term complications.
Keywords: Acellular dermal matrix (ADM); breast reconstruction; oncoplastic breast surgery.
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