Abstract P6-14-06: Prepectoral direct to implant reconstruction following nipple sparing mastectomy using the TiLOOP bra pocket

Aim: Evaluation of safety, cosmetic outcome and patients satisfaction following nipple sparing mastectomy with prepectoral direct to implant reconstruction using the TiLOOP® Bra Pocket. Background: TiLOOP® Bra Pocket is a new surgical tool consisting of a large-pore, non-absorbable synthetic mesh made from titanized monofilament polypropylene thread. It is used for immediate prepectoral implant reconstruction to fix the implant on the pectoralis major muscle and to avoid implant rotation. Material and methodes: Between October 2017 and February 2019, 57 patients underwent nipple sparing mastectomy in the certified breast cancer centre, at the AGAPLESION Markus Hospital, Frankfurt, Germany. Data was collected in a prospective registry. All of the patients underwent a prepectoral direct to implant reconstruction using the new TiLOOP® Bra Pocket. We present the first analysis of this prospective unicentric registry. To measure and to analyse the cosmetic outcome and patients’ satisfaction, the BREAST-Q questionnaire was used, an established modular questionnaire to assess patient reported outcome (PRO). Results: All of the 57 patients were available for postoperative analysis. In 35/57 (61%) of the cases a seroma occured and was worth to be punctured. The median number of punctures was 4. The volume was 70 ml in average. Seven patients had a postoperative hematoma and had to undergo another surgical procedure. Three patients developed a skin necrosis or severe wound healing problem due to bad quality of the soft tissue and skin mantle and had to undergo implant explantation. One patient suffered from implant infection but could be treated conservatively. The analysis of patients’ reported outcome via the BREAST-Q resulted in a high satifaction rate regarding the cosmetic outcome. Conclusion: Direct to implant reconstruction with prepectoral implant position by using the TiLOOP® Bra Pocket is a very promising surgical approach. In comparison to a subpectoral implant reconstruction it reduces the duration of surgery, avoids a jumping breast phenomenon and causes less postoperative pain, moreover, it leeds to a high patient satisfaction rate and shows a moderate complication rate. Follow up of our patients will continue. The next analysis will be done after 24 months. Citation Format: Marc Thill, Viviane van Haasteren, Katharina Kelling. Prepectoral direct to implant reconstruction following nipple sparing mastectomy using the TiLOOP bra pocket [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P6-14-06.