Split Pectoralis Muscle Patch: A Surgical Adjunct During Prepectoral Breast Reconstruction Salvage

Prepectoral implant-based breast reconstruction after mastectomy is a safe and reliable surgical option to restore aesthetic contour. Perioperative radiation therapy lends a morbidity to the integrity of the thin-walled mastectomy construct. Wound complications may result in implant exposure, which is potentially devastating to the reconstructed breast. Salvage often leads to implant explantation with the subsequent need for autogenous tissue grafts. Such rotational and free flap procedures result in prolonged operative times and inpatient length of stay, as well as donor site morbidity. Here we present a technique that utilizes a pedicled split pectoralis muscle flap as an internally rotated breast envelope patch to buttress a mastectomy flap repair during salvage of the prepectoral breast envelope when full-thickness tissue defect is present.