OasisLMS

The article “Immediate Breast Cancer Reconstruction with or without Dermal Matrix or Synthetic Mesh Support: A Review and Network Meta-Analysis” presents a systematic review and network meta-analysis evaluating the benefits of human ADM, xenograft ADM, synthetic mesh, and no ADM / mesh with regards to complication rates. ADMs / meshes are commonly employed by surgeons to enhance the aesthetic appearance of breasts after implant-based breast reconstruction (IBBR). The analysis specifically focused on subpectoral IBBR using an inferolateral ADM / mesh sling. The analysis demonstrated that reconstruction without ADM or mesh was associated with significantly fewer complications compared with HADM [OR 0.51; CrI 0.34–0.74], while comparisons with XADM and synthetic mesh showed trends toward fewer complications but did not reach statistical significance. The study further assessed complication profiles across techniques, including implant loss, seroma, infection, flap necrosis, and capsular contracture. By synthesizing available evidence, the authors provide guidance to help surgeons and patients weigh the clinical benefits, risks, and costs of incorporating ADM or mesh in subpectoral IBBR.

Intended Audience
This educational activity is intended for all CME-related persons including plastic surgery practitioners, residents, and other healthcare professionals.

Learning Objectives

After viewing this course, the participant should be able to:

1. Elaborate on the differences between single and two stage implant-based breast reconstruction (IBBR).
2. Describe the benefits and drawbacks of subpectoral and prepectoral reconstruction.
3. Describe the types of acellular dermal matrices (human- and xenograft-derived) and synthetic meshes, and their role in supporting implant-based reconstruction.
4. List the potential complications associated with implant-based reconstruction and discuss the differential complication rates associated with human ADM (HADM), xenograft ADM (XADM), synthetic meshes, and no use of ADM / mesh (particularly within the context of subpectoral implant-based reconstruction).
5. Evaluate the indications and considerations for IBBR compared to autologous reconstruction

Editor-in-Chief: Kevin C. Chung, MD

Co-editor: Amy S. Colwell, MD

Section Editors: Joseph J. Disa, MD, FACS

Nicole K. Le, MD, MPH

• Patient Care and Procedural Skills
• Medical Knowledge
• Practice-based Learning and Improvement

The American Society of Plastic Surgeons (ASPS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation
The American Society of Plastic Surgeons designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AMA PRA Category 1 Credit^TM: 1.0
Media:Journal Article
Release Date: 8/29/2025
Expiration Date: 8/29/2028*
Estimated time to complete this course: 1 hour
*Course access ends on course expiration date

Disclosure Policy
The American Society of Plastic Surgeons (ASPS) requires all faculty, authors, planners, reviewers, managers, staff and other individuals in a position to control or influence the content of an activity to disclose all relevant financial relationships or affiliations. All identified conflicts of interest must be resolved and the educational content thoroughly vetted by ASPS for fair balance, scientific objectivity and appropriateness of patient care recommendations. The ASPS also requires faculty/authors to disclose when off-label/unapproved uses of a product are discussed in a CME activity or included in related materials.

Disclaimer: All relevant financial relationships for planners, faculty, and others in control of content (either individually or as a group) are reviewed by the ASPS Continuing Education Committee and have been mitigated, if applicable. 

The following planners/faculty members/reviewers have no relevant financial relationships or affiliations to disclose:

Faculty:

Murphy, Donal MCh; O’Donnell, John P. MCh; Ryan, Éanna J. MD; Lane O’Neill, Billy MCh; Boland, Michael R. MCh, MSc; Lowery, Aoife J. PhD; Kerin, Michael J. FRCSI; McInerney, Niall M. MD

Plastic and Reconstruction Surgery® Editors:

Editor-in-Chief: Kevin C. Chung, MD
Co-Editor: Amy S. Colwell, MD
Section Editors: Bernard Markowitz, MD

CME Faculty:

Nicole K. Le, MD, MPH

Recognition Statement

The Continuing Medical Education (CME) credits offered by this activity are enhanced by ASPS Learner Credit Reporting for learners who have opted into this reporting. Successful completion of this CME activity enables active American Board of Surgery (ABS) members the opportunity to earn credit toward the CME requirement of the ABS's Continuous Certification program when claimed within 30 days of completion of the activity.

Participants in ASPS-accredited education who want their CME credits reported to certifying and state licensing boards must opt-in to reporting and add their NPI as well as state license ID and/or collaborating board ID(s) before claiming credit.

Directly provided by the American Society of Plastic Surgeons® (ASPS®)