1443 Comparison of Outcomes Between Immediate Direct-to-Implant Breast Reconstruction versus Two-Stage Implant Breast Reconstruction; a Systematic Review and Meta-analysis

Abstract Background Direct-to-implant (DTI) breast reconstruction is increasingly performed as the preferred method of immediate following mastectomy. The proposed advantages DTI over two-stage tissue expander (TE)/implant relate to fewer surgical procedures. This systematic review and meta-analysis aims evaluate safety efficacy versus conventional TE/implant reconstruction. Method A was (PubMed, Embase, Scopus) identify relevant studies that compared outcomes between TE/Implant reconstructions. Publications up October 2020 were included. primary outcome overall complication rate. Secondary included infection rate implant loss. Results Nineteen studies, including 32,971 implant-based reconstructions, analysed. Median age 48 years. Mean BMI 25.9. There no statistically significant difference two groups. Duration follow ranged from 1-60 months. Overall complications significantly more likely occur in group (OR 1.81 [1.17-2.79]). refers all reported seroma, haematoma, would dehiscence, infection, skin necrosis capsular contracture. Implant loss also higher cohort 1.31 [1.12-1.78]). rates Subgroup analyses, focusing on high-powered multicentre showed risks 1.51 [1.06-2.14]). Conclusions demonstrates greater risk group. These findings serve aid both patients clinicians decision-making process regarding mastectomy