Revisiting Prepectoral Breast Augmentation: Indications and Refinements

Prepectoral breast reconstruction is receiving renewed attention as a viable alternative to retropectoral reconstruction. Prepectoral breast augmentation needs to be reappraised, because patients increasingly demand safer and less invasive procedures with a shorter recovery period.

This study aimed to evaluate prepectoral breast augmentation combined with a microtextured prosthesis to determine whether it could be a useful alternative to retropectoral augmentation.

This study included 76 women (152 breasts) who were indicated for primary breast augmentation. The inclusion criterion was a pinch test result of more than 3 cm at the upper pole of the breast. A total subfascial dissection was performed with endoscopic assistance. Microtextured implants were placed through an axillary approach in the subfascial space.

The mean follow-up period was 12 months (range, 6-23 months). The mean implant volume was 278.1 mL (range, 185-360 mL). Autologous fat grafts were applied in 12 patients. No patients developed seroma, capsular contracture, or malposition during the follow-up period. Two patients expressed concerns of minor contour visibility, but no patients required revisional surgery.

The drawbacks of prepectoral implant placement were sought to be managed by fascial coverage and microtextured prostheses. Although the follow-up duration was short, major complications were not encountered with Motiva Ergonomix SilkSurface implants. Therefore, prepectoral augmentation with microtextured prostheses should be reconsidered as a potential alternative to retropectoral methods because of the recent advances in surgical techniques and device technology.