The objective of this clinical trial is to generate robust data that demonstrates clinical performance and safety of a polycaprolactone (PCL) breast scaffold combined with autologous fat grafting (AFG) in women who seek a revision surgery of a breast implant used for breast augmentation. The material (PCL) has been in clinical use for many decades and is absorbable. This study follows the successful completion of a 2-year evaluation of the safety and feasibility of this technique performed by the Royal Brisbane and Women's Hospital (ClinicalTrials.gov ID: NCT05437757). The main question it aims to answer is: "Is PCL Breast Scaffold with autologous fat graft a safe and effective method of soft tissue reconstruction following breast implant revision?". Participants will: * Undergo removal of their existing silicone breast implant (if not previously removed), * Receive implantation of a PCL Breast Scaffold combined with autologous fat grafting (AFG), and * Attend follow-up visits at 1 week, 3 months, 6 months, and annually for up to 5 years for clinical assessments and questionnaires.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
OTHER
Masking
NONE
Enrollment
73
The PCL Breast Scaffold is implanted either immediately following the removal of a silicone implant or during a delayed procedure. The surgery uses the same surgical pocket from the previous augmentation for insertion of the PCL Breast Scaffold, or, if implants have been previously removed, a new surgical pocket will be created. The PI will ensure accurate placement and secure fixation of the scaffold in the desired anatomical position. Autologous fat grafting (AFG) is then performed: the fat cells are harvested from the abdomen and/or thighs and injected into the implanted scaffold at the time of initial implantation. Lastly, after the AFG has been performed, wound closure and dressing will be conducted as per standard procedure. Sterile bandaging shall be initially applied and the wound reviewed daily whilst an inpatient. In conjunction with scaffold implantation, concurrent breast procedures may be performed on a case-by-case basis (e.g., Mastopexy,...).
Macquarie University Hospital
Sydney, New South Wales, Australia
Westmead Hospital, Lakeview Private Hospital
Sydney, New South Wales, Australia
Royal Brisbane and Women's Hospital (RBWH), Herston Biofabrication Institute (HBI)
Brisbane, Queensland, Australia
Zealand University Hospital
Roskilde, Region Sjælland, Denmark
Evangelisches Krankenhaus Göttingen-Weende
Göttingen, Lower Saxony, Germany
Universitätsklinikum Münster
Münster, North Rhine-Westphalia, Germany
Evaluation of the occurrence rate of moderate and severe device-related (probable and causal) AEs aftersurgical revision of permanent breast implants within 12 months
Number of moderate and severe AEs with a probable or causal relationship to the device falling under pre-defined category over time
Time frame: Assessed at post-surgery, at 1 week and at 3-, 6- and 12-month post sugery
Breast revision surgery rate
Number of breast revision surgeries categorized by reason and time
Time frame: Assessed at post-surgery and at 1-week, 3-month, 6-month, 1-year, 2-year, 3-year, 4-year and 5-year post-surgery
Rate and severity of all AEs related to device and/or procedure
Number of AEs categorised by relationship with device and/or procedure (possible, probable, causal), severity and type over time
Time frame: Assessed at post-surgery, 1-week, 3-month, 6-month, 1-year, 2-year, 3-year, 4-year and 5-year post-surgery
Total breast volume retention (3D Imaging)
Total breast volume primarily assessed through 3D imaging. Supportive data generated by: * Dynamic contrast enhanced Magnetic Resonance Imaging (DCE-MRI); * Breast anthropomorphic measurements taken with tape measure or with Vectra imaging system (Sternal notch to nipple (SN-N), Nipple to Inframammary Fold (N-IMF), Overbust measurement, Underbust measurement, Chest circumference at highest projection); * Digital photos
Time frame: Assessed at enrolment and at 3-month, 6-month, 1-year, 2-year, 3-year, 5-year post-surgery
Assessment of patient satisfaction, quality of life, body image, and psychological well-being using validated questionnaires (BREAST-Q)
Patient-reported outcomes will be measured using the validated BREAST-Q questionnaire. Results are reported as a transformed score range from 0 to 100, with higher scores reflecting a better outcome.
Time frame: Assessed at enrolment and at 3-month, 6-month, 1-year, 2-year, 3-year, 4-year, 5-year post-surgery
Assessment of patient satisfaction, quality of life, body image, and psychological well-being using a 5-point Likert scale questionnaire
Patient-reported outcomes will be measured through a 5-point Likert scale questionnaire. Scores range from 1 to 5, with higher scores indicating better outcomes.
Time frame: Assessed at 3-month, 6-month, 1-year, 2-year, 3-year, 4-year, 5-year post-surgery
Assessment of surgical usability and surgeon satisfaction using a 5-point Likert scale questionnaire
The 5-point Likert scale questionnaire is administered to the PIs performing the surgical procedure. Scores range from 1 to 5, with higher scores indicating a better usability and greater surgeon satisfaction.
Time frame: Assessed at surgery and at 3-month, 6-month, 1-year, 2-year, 3-year, 4-year, 5-year post-surgery
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