摘要

Objectives: -define the advantages of immediate breast reconstruction -present the types of immediate breast reconstruction -define the advantages of using breast implants and compare the various surfaces -define the role of ADMs in relation to the implant surface -analyse the global long-term cost of ADM+implant versus implant alone Introduction: DTI breast reconstruction gains increasing popularity mostly because of better understanding of recurrence risk but also because of better genetic diagnosis. Implant-based reconstruction remains the easiest and the fastest, without sacrificing other anatomical structures. The choice of implant shape and surface depends not only on the contralateral breast but also on the thickness of the mastectomy flaps. ADMs can achieve a better coverage of the implant and lower the rate of capsular contracture. The cost of ADMs limits however its wide use. Materials / method: -personal cases Results: Bigger contralateral breast, thicker flaps can give a good aesthetic result with round smooth or nanotextured implants while thinner patients often need an anatomical microtextured or polyurethane implant. The ADMs can significantly reduce the risk of capsular contracture or implant exposure. Conclusion: The choice of implant shape and surface should be tailored to each case. Each surface has its advantages and disadvantages, the ADMs remaining an important, but sometimes prohibitively expensive tool in the surgeon's toolbox.