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Updated: Jun 26, 2025

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Prepectoral Prosthetic Breast Reconstruction Without ADM Using a Subfascial Approach.

Donald A Hudson1

  • 1UCT Private Academic Hospital, Anzio Rd, Observatory, Cape Town, South Africa. Donald.hudson@uct.ac.za.

Aesthetic Plastic Surgery
|May 8, 2024
PubMed
Summary
This summary is machine-generated.

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This study presents a mesh-free technique for immediate prepectoral breast reconstruction, showing a low extrusion rate. This method offers an extra layer of prosthetic coverage suitable for all breast ptosis grades.

Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Breast Reconstruction

Background:

  • Immediate prosthetic breast reconstruction has advanced to prepectoral techniques.
  • A novel approach involves raising the pectoral and serratus fascia superiorly.
  • Historically, Vicryl mesh was used for fascial defects, but primary closure or pectoralis muscle pocket creation (direct to implant - DTI) is now preferred.

Purpose of the Study:

  • To evaluate a mesh-free technique for immediate prepectoral breast reconstruction.
  • To assess the outcomes of this technique regarding prosthetic coverage and extrusion rates.
  • To determine the applicability of the technique across different grades of breast ptosis.

Main Methods:

  • Retrospective analysis of 47 patients (80 breasts) over a 4-year period.
Keywords:
FasciaNo ADMProsthetic prepectoral breast reconstruction

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  • Data collection included patient demographics, reconstruction type (tissue expander or DTI), and follow-up outcomes.
  • Calculation of percentage fascial coverage of the prosthesis.

    • Main Results:

    • Forty-seven patients (mean age 42) underwent reconstruction; 35 (61 breasts) utilized primary closure without mesh.
    • Prosthetic extrusion occurred in 8 breasts (6 without mesh).
    • Mean fascial coverage was 74%, with a low extrusion rate reported for the mesh-free technique.

    Conclusions:

    • A mesh-free technique for immediate prepectoral reconstruction provides an additional layer of prosthetic cover.
    • This method is applicable for all grades of breast ptosis.
    • The technique demonstrates a low rate of prosthetic extrusion.