why applying to prepectoral implant course

Prepectoral breast reconstruction has emerged as an excellent technique for postmastectomy reconstruction, as it allows for full preservation of a patient's pectoralis major muscle and chest wall function. This reduces pain, eliminates animation deformity, and results in high patient satisfaction.

Full Answer

What is prepectoral implant placement?

“Prepectoral implant placement is a single-stage surgery that avoids implant motion with shoulder movement. If the skin is too thin, then the implant shape and wrinkling will be more visible and there may be more capsular contracture.”

How do prepectoral breast implants work?

How Prepectoral Breast Reconstruction Works. With prepectoral implants, either two-staged with a tissue expander or direct-to-implant, the implant is placed above the muscle. Since there is no muscle coverage to protect the implant, the implant is wrapped in an acellular dermal matrix (ADM).

What is prepectoral reconstruction for breast implants?

A newer approach, called prepectoral reconstruction, places the implants in the chest over the pectoris major muscle, just under the skin. One of the advantages is that it can result in less pain during recovery.

What are an implant and how do they work?

An implant is used to fill in this space and restore the breast mound. Traditionally, implants were placed in a pocket created completely under the chest wall muscle, also known as the pectoralis major muscle, or simply the pectoral muscle.

What are Prepectoral implants?

Pre-pectoral breast reconstruction is one of the newest options in implant breast reconstruction that involves placing the implant directly under the skin on top of the chest muscle, without the need to cut or lift the muscles.

What is Prepectoral reconstruction?

Prepectoral reconstruction is a technique that eliminates dissection of the pectoralis major by placing the prosthesis completely above the muscle with complete acellular dermal matrix coverage.

What are the benefits of breast reconstruction?

The benefits of breast reconstruction potentially include improved body image, self-esteem, well-being, and a possible survival advantage. Breast cancer surgery is a complex process of decision-making involving the patient, surgeon, and plastic surgeon. In the end, it is the patient's choice how she should proceed.

What is Subpectoral breast reconstruction?

Subpectoral Breast Reconstruction Surgery During this type of breast reconstruction, the pectoralis major muscle is elevated from the chest wall, and the surgeon will place the implant behind this muscle. This type of surgery is a two-step process.

Can you get bigger implants after mastectomy?

In most cases, women who have had breast reconstruction can opt for bigger implants. This adjustment may require the use of a tissue expander in order to enlarge the space that will receive the larger implant.

What is direct to implant reconstruction?

What is a direct-to-implant breast reconstruction? Also known as an immediate implant breast reconstruction, this is a procedure in which a breast implant is placed at the time of a mastectomy in a single stage without a tissue expander or flap procedure.

What is the best option for breast reconstruction?

The pre-pectoral procedure is the most minimally invasive breast reconstruction option. Your doctor can perform a mastectomy by removing breast tissue through a small incision underneath the breast. Through this incision, a tissue expander can be placed on top of the muscle to create a breast mound.

Do you have feeling in your breast after reconstruction?

Some things to keep in mind: Certain types of reconstruction surgery do not restore normal feeling to your breast, but in other types some feeling might return over time. It may take up to about 8 weeks for bruising and swelling to go away.

Is Delayed reconstruction better?

If radiation therapy is part of the treatment plan, delayed reconstruction is usually recommended for the reasons mentioned above. Other advantages of delaying reconstruction include: The surgical site has had time to heal. If the patient required radiation therapy, the radiated skin has also had time to heal.

What is Prepectoral?

Prepectoral reconstruction is a technique that eliminates dissection of the pectoralis major by placing the prosthesis completely above the muscle with complete acellular dermal matrix coverage.

What is Subpectoral placement?

Submuscular (also known as Subpectoral) implant placement is somewhat misleading. The fan-shaped muscle is detached from bottom along the ribs, and the implant is placed underneath. However, the pectoralis major is a short muscle, and a submuscular implant placement only covers the top half of the implant.

What does Subpectoral mean?

Definition of subpectoral 1 : situated under the pectoralis muscles. 2 : situated or seeming to arise beneath the chest.

What is the purpose of implants?

An implant is used to fill in this space and restore the breast mound. Traditionally, implants were placed in a pocket created completely under the chest wall muscle, also known as the pectoralis major muscle, or simply the pectoral muscle.

Why do you put implants above the pectoral muscle?

One major advantage of placing the implant above the muscle ( Pre-pectora l) is improved cleavage. When the implants are placed under the muscle, as the pectoral muscles contracted they pushed the implant sideways away from the midline and therefore negatively impacted cleavage.

What are the disadvantages of prepectoral technique?

The main disadvantage of the prepectoral technique, is the fact that there is less soft tissue coverage over the implant, which makes the wrinkles of the implant more visible. This is usually solved with fat grafting and using implants that wrinkle less.

What muscle is used to squeeze implants?

When the patient activated the pectoral muscle, it squeezed the implant and elevated the skin and nipple over the implant creating an animation deformity. In addition to being cosmetically displeasing, many patients complain of tightness when the implants are placed under the muscle.

Where is the implant placed?

The implant is completely covered with a thick sheet of acellular dermal matrix (human skin) and is placed under the breast skin and above the muscle. The skin that is used to wrap the implant in the pre-pectoral technique is thicker than the one that was classically used for the partial coverage. One major advantage of placing ...

Can you get a pre pectoral reconstruction after mastectomy?

Any patient can get a pre-pectoral reconstruction, but their skin after mastectomy has to be thick enough and has to have a good blood flow. The results have been very comparable to the classic partial muscle coverage technique with improved cleavage, less discomfort, and no animation.

Is the pocket of a dermal implant covered by muscle?

Over the past decade, and with the advances in collagen matrices and acelluar dermal products, the pocket was converted to partial submuscular, where the upper half of the implant is covered by the muscle, and the lower half is covered by a sheet of acellular dermal matrix (treated human skin that has no cells).

What is the difference between breast reconstruction and prepectoral reconstruction?

There are a lot of differences between the prepectoral and standard breast reconstruction techniques. The prepectoral technique places the implants above the chest muscles. Not only that , it uses a purified human skin product to support the implants. This process replaces breast tissue, but the surrounding skin remains intact.

What is the goal of plastic surgeons?

As plastic surgeons, our goal is to make survivors of breast cancer feel complete again through the means of reconstructive surgery. Every day, breakthroughs in medicine, science, and technology enable us to find new ways to restore the body.

What happens to women after breast reconstruction?

The following benefits show what will happen to women when they decide to undergo prepectoral breast reconstruction: Less Pain – Unlike standard reconstruction techniques, patients will experience less pain if they undergo prepectoral reconstruction. No Hospital Stay – Women can instantly go home after surgery.

How does a prepectoral breast implant work?

With prepectoral implants, either two-staged with a tissue expander or direct-to-implant, the implant is placed above the muscle. Since there is no muscle coverage to protect the implant, the implant is wrapped in an acellular dermal matrix (ADM).

What is the procedure called when a woman receives implants?

While new technology allows some women to receive implants during the mastectomy procedure (called “direct-to-implant”), the typical subpectoral implant-based reconstruction uses a two-stage approach. First, a tissue expander is placed at the time of the mastectomy.

How do breast implants work?

While new technology allows some women to receive implants during the mastectomy procedure (called “direct-to-implant”), the typical subpectoral implant-based reconstruction uses a two-stage approach. First, a tissue expander is placed at the time of the mastectomy. After expanding to the desired volume, the patient is returned to the operating room for exchange of the tissue expander for the final breast implant, almost always a silicone gel implant. There are several issues with this technique: 1 It involves placing the implant under the pectoralis major muscle, which can be painful. 2 Because it is under the muscle there is what is called “animation of the implant”. This means that as the muscle contracts, the implant tends to move upwards, and then back again when the muscle relaxes.

What are the issues with prepectoral reconstruction?

Like subpectoral reconstruction, there are also issues with the prepectoral reconstruction technique: The mastectomy flaps, the skin that will cover the new implant, must be thick enough to provide good blood flow to the skin.

What is breast implant surgery?

Implant-based breast reconstruction#N#X The creation of an artificial breast performed by a plastic surgeon.#N#remains the most common form of mastectomy#N#X An operation removing all or part of the breast.#N#reconstruction after breast cancer. Breast implant surgery represents approximately two-thirds of all breast reconstructions. The remaining reconstructions are autologous or “flap” reconstruction, which uses tissue from your own body to reconstruct the breast.

What is tissue expander?

First, a tissue expander is placed at the time of the mastectomy. After expanding to the desired volume, the patient is returned to the operating room for exchange of the tissue expander for the final breast implant, almost always a silicone gel implant. There are several issues with this technique:

Can a breast implant be rippling?

If the mastectomy flaps have good blood flow, but are thin, the implant may be easily recognized due to rippling that is not covered by thicker soft tissue. A prepectoral breast implant might be a great option for certain patients.

Subpectoral or Prepectoral

The decision to go subpectoral or prepectoral is usually based on the thickness of the natural tissue and the patient’s ability to hide the edges of the implant. There are three layers of soft tissue that surround the breasts and these include the outer layer of skin, the fat and connective tissue, and the breast gland itself.

Benefits of Subpectoral Implants

Studies have suggested that women with subpectoral breast implants are less likely to develop capsular contracture. This is a condition characterized by a firm and often painful condition that occurs when scar tissue forms around the implant.

Benefits of Prepectoral Implants

In the first few days after surgery prepectoral implants are occasionally less painful. However, many surgeons will say that this should not be a deciding factor as patients that have subpectoral implants do very well by controlling the pain with the medication that is prescribed to them.

What is prepectoral breast reconstruction?

Breast reconstruction for breast cancer patients can be done using a range of methods. One of them is by using a “prepectoral” prosthesis wrapped in ADM ( acellular dermal matrix ). It is the newest type of implant-based breast reconstruction method.

Why is prepectoral reconstruction done?

Through the subpectoral method, breast implants are placed under the chest. During the procedure, some of the chest muscle is cut to place the implant underneath.

What does prepectoral breast reconstruction involve?

With prepectoral implants, either direct-to-implant or with a tissue expander, the implant is placed above the muscle.

How do you prepare for the surgery?

The determination as to whether this is the best option would be made at the time of the consultation with a specialist. Women who benefit from this procedure are usually those who have small to medium sized breasts that do not sag very much.

Aftercare

After surgery, patients can expect some swelling, soreness and bruising for 2 to 3 weeks. The plastic surgeon will advise you about bathing, showering and wound care.

Alternatives to prepectoral implants

The more common methods used for breast reconstruction include “subpectoral” and “dual-plane” approaches.