Bridging autologous reconstruction with pre-pectoral tissue expanders

Area of Science:

• Plastic Surgery
• Breast Reconstruction
• Microsurgery

Background:

• Pre-pectoral breast reconstruction is gaining traction, with studies indicating results comparable to traditional sub-pectoral approaches.
• Published literature supports acceptable short-term outcomes for pre-pectoral reconstruction regarding infection, expander failure, and patient satisfaction, even in radiated patients.

Purpose of the Study:

• To evaluate the efficacy and advantages of an immediate pre-pectoral expander reconstruction using a "piggy-back" technique.
• To assess this method as a standard approach preceding delayed microsurgical free tissue transfers, specifically deep inferior epigastric perforator (DIEP) flaps.

Main Methods:

• Implementation of a "piggy-back" method for immediate pre-pectoral expander placement over four years.
• Subsequent delayed immediate microsurgical free tissue transfers for definitive breast reconstruction.

Main Results:

• The "piggy-back" pre-pectoral technique has demonstrated numerous advantages in clinical practice.
• This method has become the standard of care in many cases for patients undergoing deep inferior epigastric perforator (DIEP) flap reconstruction.

Conclusions:

• The pre-pectoral "piggy-back" expander technique is a viable and advantageous method for immediate breast reconstruction.
• This approach facilitates successful delayed immediate microsurgical free tissue transfers, including DIEP flaps, offering comparable or improved outcomes.