Revising Prepectoral Breast Reconstruction

Adam M. Goodreau, M.D.; Cassandra R. Driscoll, M.D.,  M.P.H.; Anthony Nye, M.D.; Lauren C. Nigro, M.D.; Nadia P. Blanchet, M.D.

Summary: Prepectoral prosthetic breast reconstruction continues to gain popularity, largely due to its decreased postoperative pain, animation deformity, and operative time as compared to subpectoral reconstruction. Widespread use has  led to opportunities for surgical revisions. While some techniques for submuscular reconstruction revisions, such as implant exchange and fat grafting, also apply to prepectoral revisions, others require modification for the prepectoral space.  The prosthesis’ unique reliance on the mastectomy flaps and acellular dermal  matrix for support leads to a progressive alteration of the breast footprint, conus,  envelope, and nipple-areola complex position.

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