Prepectoral breast reconstruction

         In the last few years,preceptorial(in front of the pectoral muscle) breast reconstruction has evolved into another option for women who dealing with breast cancer or high risk for breast cancer. Research and published journal articles are demonstrating excellent results with high patient satisfaction at 3 years. Yes, that means the current literature is only looking at a relatively short time period.
         Prior to this time breast tissue expanders or implants were placed underneath the pectoral muscle because plastic surgeons felt the extra muscle tissue over the implants helped maintain softness over time. This allowed  patients who had risks of healing problems an option for reconstruction after mastectomy. When skin flaps left after mastectomy healed slowly, the muscle added an extra healthy layer to limit exposure of expanders or implants. This technique is still commonly used since some patients have healing risks. These risks are related to smoking, diabetes, obesity, and many other systemic issues.
        Prepectoral breast reconstruction is available for healthy women with minimal risks. Newer cohesive gel breast implants have less risk of hardening than older implants. The use of ADM (dermal matrix) has also blessed the risk of hardening  and has provided a softer scar capsule around the implant. This type of surgery is less painful and allows patients to leave hospitals earlier. Recovery and return to activity is typically easier.
www.abcsurg.com        This type of reconstruction is technically easier for your plastic surgeon,but careful patient selection is still critical. Your plastic surgeon must assess the quality and health of the remaining skin after your mastectomy when immediate breast reconstruction is planned.This is not always easy. The breast surgeon plays a large role in keeping these skin flaps healthy and not all breast surgeons or plastic surgeons are the same. Experience in patient selection and surgical dissection is important to obtain excellent results and minimize recovery. This option can be used in nipple sparing mastectomy,skin sparing mastectomy, and delayed reconstruction of the breast.