Prepectoral Means Above the Chest Muscle
“Prepectoral” describes where an implant or tissue expander sits. In this type of reconstruction, the device is placed above the pectoralis major muscle rather than beneath it.
With an under-the-muscle reconstruction, part of the chest muscle is elevated to create space for the implant. A prepectoral approach leaves that muscle in place. The American Society of Plastic Surgeons notes that avoiding muscle elevation can shorten recuperation for some patients and prevents the implant from moving with chest-muscle contraction.
Prepectoral and Direct-to-Implant Describe Different Things
These terms sometimes appear together, but they aren’t interchangeable. Prepectoral tells you where the implant or expander is placed. Direct-to-implant tells you when the permanent implant is placed.
A direct-to-implant procedure places the permanent breast implant at the time of mastectomy and reconstruction in select patients. Other people may first receive a tissue expander, which gradually creates space before it is exchanged for a permanent implant. Either approach may involve placement above the muscle depending on the circumstances.
Our prepectoral reconstruction gallery can give you a sense of how treatment may be staged. Individual results vary.
What Factors Affect Candidacy?
There isn’t one reconstruction method that fits everyone. Your anatomy, remaining breast skin, cancer treatment, health history, and previous radiation can all shape the discussion.
The condition and blood supply of the mastectomy skin are particularly important with implant-based reconstruction. Our surgeons use SPY technology during certain immediate reconstruction procedures to evaluate blood flow to the breast skin in real time. That information can help them judge which tissue has adequate circulation during surgery.
You May Have More Than One Reconstruction Route
Prepectoral reconstruction is only one possibility. American Surgical Arts also performs implant-based reconstruction with tissue expanders, direct-to-implant reconstruction, and tissue-based techniques such as DIEP and TRAM flaps. Nipple reconstruction or areola tattooing may come later in the reconstructive process for some patients.
You shouldn’t have to determine the right technique from online research alone. Dr. Bidic and Dr. Gundlapalli can review your cancer treatment, anatomy, tissue condition, and priorities together and explain which routes make sense in your situation.
Schedule a Breast Reconstruction Consultation
You don’t need to determine the right reconstruction technique on your own. Contact us to meet with Dr. Bidic or Dr. Gundlapalli at American Surgical Arts in Mullica Hill, New Jersey, and discuss how your treatment history, anatomy, and reconstructive priorities may affect your options. Call 856-362-8898 to schedule a breast reconstruction consultation.