RECONSTRUCCIÓN MAMARIA CON IMPLANTES TRAS MASTECTOMÍA: PLANO PREPECTORAL FRENTE A SUBPECTORAL. REVISIÓN NARRATIVA DE COMPLICACIONES, RESULTADOS ESTÉTICOS Y CALIDAD DE VIDA
Authors/Creators
- 1. Universidad El Bosque. Bogotá, Colombia
- 2. Corporación Universitaria Empresarial Alexander von Humboldt. Colombia.
- 3. Universidad del Valle. Colombia
Description
Tipo de artículo: Artículo de revisión
Objetivo. Sintetizar la evidencia comparativa sobre el plano prepectoral frente al subpectoral para la colocación del implante o expansor en la reconstrucción mamaria tras mastectomía, con énfasis en complicaciones, secuelas estéticas dependientes del plano y calidad de vida.
Métodos. Se realizó una revisión narrativa orientada por los criterios de calidad de SANRA. La búsqueda se llevó a cabo en PubMed/MEDLINE, Scopus, Web of Science, Embase y Cochrane Library, entre enero de 2016 y junio de 2026, en inglés y español. La selección siguió un flujo no sistemático de identificación, cribado e inclusión. Los hallazgos se agruparon en cuatro ejes temáticos y se sintetizaron descriptivamente mediante un harvest plot, sin estimador agrupado.
Resultados. Se incluyeron 22 estudios, entre metaanálisis y cohortes comparativas. Las complicaciones perioperatorias tempranas (seroma, hematoma, infección, necrosis del colgajo y dehiscencia), así como el fallo reconstructivo, fueron mayoritariamente comparables entre planos. La contractura capsular mostró resultados discrepantes: los metaanálisis favorecieron el plano prepectoral, mientras que las cohortes individuales no confirmaron de forma consistente esa diferencia. Las secuelas dependientes del plano configuraron un intercambio clínico definido: el plano prepectoral se asoció con menor deformidad de animación, dolor posoperatorio y migración del implante, pero con mayor frecuencia de rippling. La calidad de vida medida con BREAST-Q fue globalmente similar, con señales aisladas por dominio a favor de uno u otro plano.
Conclusiones. No se identificó superioridad global de un plano sobre el otro. La elección debe individualizarse según la secuela que se busque evitar y las características del colgajo. La discrepancia en contractura capsular y la heterogeneidad de los resultados reportados por las pacientes justifican estudios aleatorizados, con seguimiento prolongado y desenlaces estandarizados.
Abstract (English)
Article type: Review article
Objective. To synthesize the comparative evidence on the prepectoral versus subpectoral plane for implant or tissue expander placement in postmastectomy breast reconstruction, with emphasis on complications, plane-dependent aesthetic sequelae, and quality of life.
Methods. A narrative review guided by the SANRA quality criteria was conducted. The search was performed in PubMed/MEDLINE, Scopus, Web of Science, Embase, and the Cochrane Library, from January 2016 to June 2026, in English and Spanish. Study selection followed a non-systematic flow of identification, screening, and inclusion. Findings were grouped into four thematic axes and descriptively synthesized using a harvest plot, without a pooled estimator.
Results. Twenty-two studies were included, comprising meta-analyses and comparative cohort studies. Early perioperative complications, including seroma, hematoma, infection, flap necrosis, and wound dehiscence, as well as reconstructive failure, were mostly comparable between planes. Capsular contracture showed discrepant findings: meta-analyses favored the prepectoral plane, whereas individual cohort studies did not consistently confirm this difference. Plane-dependent sequelae reflected a defined clinical trade-off: the prepectoral plane was associated with less animation deformity, postoperative pain, and implant migration, but with a higher frequency of rippling. Quality of life measured with BREAST-Q was generally similar, with isolated domain-specific signals favoring one plane or the other.
Conclusions. No overall superiority of one plane over the other was identified. The choice should be individualized according to the sequela to be avoided and the characteristics of the mastectomy flap. The discrepancy regarding capsular contracture and the heterogeneity of patient-reported outcomes justify randomized studies with prolonged follow-up and standardized endpoints.
Files
sanum_v10_n4_a7.pdf
Additional details
Additional titles
- Translated title (English)
- PREPECTORAL VERSUS SUBPECTORAL IMPLANT-BASED BREAST RECONSTRUCTION AFTER MASTECTOMY: A NARRATIVE REVIEW OF COMPLICATIONS, AESTHETIC OUTCOMES, AND QUALITY OF LIFE
Dates
- Collected
-
2026-07-08manuscrito recibido
- Accepted
-
2026-09-07evaluación doble ciego
- Available
-
2026-10-29publicación en numero de la revista
Software
- Repository URL
- https://revistacientificasanum.com/
- Development Status
- Active
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