Prepectoral direct-to-implant breast reconstruction using a novel acellular dermal matrix: framework for a cohort study

This retrospective cohort study includes all consecutive patients who underwent prepectoral DTI breast reconstruction with FlexHD Pliable PRE between February 2017 and June 2024. Exclusion criteria include subpectoral placement, autologous reconstruction, and follow-up under 12 months. Patient demographics, procedural details, and postoperative outcomes (including capsular contracture, implant malposition, infection, implant loss, and other potential complications) will be collected. Capsular contracture will be defined as Baker grade III/IV. Univariate analysis and multivariable logistic regression will identify independent predictors of contracture.