SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Breast Cancer
A systematic review and meta‑analysis on the prepectoral and partial subpectoral immediate single‑stage Implant-Based Breast Reconstruction Using ADM
Provisionally accepted
- 1Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
- 2Department of Radiology, People's Hospital of Leshan, Leshan, China
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Introduction: Acellular dermal matrices (ADMs) have made immediate single-stage prepectoral breast reconstruction (PBR) feasible and have promoted the application and development of partial subpectoral breast reconstruction (SBR). The type of mesh is regarded as a key factor influencing the safety of breast reconstruction. The optimal choice between prepectoral and partial subpectoral approaches for ADM-assisted immediate single-stage prosthetic breast reconstruction remains controversial. This study aimed to compare the safety profiles of these two surgical techniques. Methods: A systematic literature search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library. All included patients underwent immediate single-stage implant-based breast reconstruction using ADM. Patient characteristics and postoperative complications were collected and summarized. Data analysis was performed using Cochrane RevMan and IBM SPSS software. Results: The meta-analysis incorporated 1,557 reconstructed breasts from eight eligible observational studies. Overall, PBR significantly reduced the total complication rate following immediate single-stage breast reconstruction compared with SBR. Additionally, PBR was associated with significantly lower rates of postoperative hematoma and skin–nipple necrosis compared with SBR. Conclusion: The meta-analysis demonstrated that PBR was associated with lower safety risks for ADM-assisted immediate single-stage implant-based breast reconstruction.
Keywords: Acellular dermal matrix, Breast reconstruction, Immediate single-stage, Postoperative Complications, Prepectoral, Subpectoral
Received: 09 Nov 2025; Accepted: 06 Feb 2026.
Copyright: © 2026 Zhang, Zhao, Huang, Zhang, Li, Du and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yuyao Liu
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