{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T05:13:25Z","timestamp":1792732405397,"version":"4.5.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Immediate prepectoral breast reconstruction has emerged as a prominent alternative to subpectoral techniques, offering favorable outcomes in selected patients. Among available options, implant coverage with acellular dermal matrix (ADM) and the use of polyurethane (PU)-coated implants without ADM represent 2 widely adopted strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of the authors this study is to examine the comparative efficacy and complication profiles of implant coverage with ADM and the use of PU-coated implants without ADM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 97 patients (135 breasts) undergoing immediate prepectoral breast reconstruction following nipple-sparing, skin-sparing, or skin-reducing mastectomy between April 2015 and October 2019. Patients were stratified into 2 groups: those receiving ADM-covered textured implants and those receiving PU-coated implants. Outcomes assessed included early (&amp;lt;4 weeks), mid-term (&amp;gt;4 weeks), and long-term (\u22651 year) complications, as well as aesthetic results evaluated through blinded assessment using a standardized Likert scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PU-coated implants were associated with significantly lower rates of early postoperative seroma (2.9% vs 33.8%, P &amp;lt; .001) and infection (1.4% vs 6.2%). At 5 years, the incidence of severe capsular contracture (Baker Grade 3-4) was markedly higher in the ADM group (47.7% vs 24.3%, P &amp;lt; .001), particularly in patients who had not received postmastectomy radiotherapy. No significant differences were observed in the incidence of rippling or step-off deformities. Aesthetic outcomes were superior in the PU group, with significantly better breast symmetry and global aesthetic evaluation (P = .021).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PU-coated implants offer a safer and more effective approach in immediate prepectoral breast reconstruction, with reduced complication rates and improved aesthetic outcomes compared with ADM-covered implants. Patient-specific anatomical and oncologic factors should guide implant selection to optimize surgical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence: 4 (Therapeutic)<\/jats:title>\n                    <jats:p\/>\n                  <\/jats:sec>","DOI":"10.1093\/asj\/sjaf158","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T11:54:23Z","timestamp":1754049263000},"page":"38-48","source":"Crossref","is-referenced-by-count":7,"title":["Prepectoral Breast Reconstruction: Early and Long-Term Complications and Outcomes of Total Coverage Acellular Dermal Matrix and Implants Vs Polyurethane-Coated Implants Without Use of Acellular Dermal Matrix"],"prefix":"10.1093","volume":"46","author":[{"given":"Marzia","family":"Salgarello","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3373-7303","authenticated-orcid":false,"given":"Mauro","family":"Barbera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0041-5420","authenticated-orcid":false,"given":"Giuseppe","family":"Visconti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5828-2851","authenticated-orcid":false,"given":"Lorenzo","family":"Scardina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Franceschini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alba","family":"Di 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shadows","volume":"73","author":"Ghilli","year":"2024","journal-title":"Breast"},{"key":"2025121611013845900_sjaf158-B3","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1097\/PRS.0000000000003627","article-title":"Prepectoral breast reconstruction: a safe alternative to submuscular prosthetic reconstruction following nipple-sparing mastectomy","volume":"140","author":"Sbitany","year":"2017","journal-title":"Plast Reconstr Surg"},{"key":"2025121611013845900_sjaf158-B4","doi-asserted-by":"publisher","first-page":"7S","DOI":"10.1097\/PRS.0000000000004045","article-title":"Important considerations for performing prepectoral breast reconstruction","volume":"140","author":"Sbitany","year":"2017","journal-title":"Plast Reconstr Surg"},{"key":"2025121611013845900_sjaf158-B5","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1097\/SAP.0000000000002059","article-title":"Prepectoral versus subpectoral direct to implant immediate breast 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