The use of an ultrasonic dissection device for the P1 method in prosthetic breast reconstruction
- Author:
Min Young LEE
1
;
Joo Yeop LEE
;
Dae Hyun LEE
;
Seung Yong SONG
Author Information
- Publication Type:Original Article
- From:Archives of Aesthetic Plastic Surgery 2024;30(4):126-131
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:The P1 method in prosthetic breast reconstruction has the advantage of preventing rippling and ensuring a smooth upper pole contour. This study presents our experience with using an ultrasonic dissection device instead of a monopolar electrocautery device for the P1 method.
Methods:Patients who underwent prepectoral breast reconstruction at our institution between June and September 2021 were retrospectively reviewed. Among the 39 breasts analyzed, 17 underwent the P1 procedure using an ultrasonic dissection device for the superior slip of the pectoralis major muscle, while 22 underwent P0 prepectoral breast reconstruction. We compared surgical outcomes, including operative time, presence of rippling, capsular contracture, and animation deformities, and complications such as seroma, hematoma, and mastectomy skin flap necrosis.
Results:Patient demographics were comparable between the groups, except for chemotherapy exposure. Rippling occurred more frequently in the P0 group (36.4% vs. 23.5%); however, capsular contracture was absent in the P1 group. Despite these observations, the differences lacked statistical significance. The average operative time was longer in the P1 group than in the P0 group (104.35 minutes vs. 90.05 minutes), although this difference was not statistically significant (P=0.095). There were no instances of postoperative hematoma, infection, implant exchange, animation deformity, or implant explantation in either group.
Conclusions:Using an ultrasonic energy device for additional dissection in the P1 method was non-inferior in terms of complications such as bleeding, infection, or animation deformity. The ultrasonic device can facilitate safe and effective dissection when elevating the superior pectoralis muscle slip, despite requiring additional operative time.
