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Related Experiment Video

Updated: Jan 12, 2026

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Selective Pectoralis Muscle Denervation Reduces Capsular Contracture in Sub-Pectoral Breast Reconstruction. Long-Term

Marco Bernini1, Federico Spolveri2, Margherita Serra1

  • 1Breast Surgery, Breast Unit, Breast Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

ANZ Journal of Surgery
|November 3, 2025
PubMed
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Selective denervation of the pectoralis major muscle (PMM) in retropectoral breast reconstruction significantly reduced capsular contracture (CC) rates. This novel technique also improved patient satisfaction, offering better outcomes for implant-based breast reconstruction (IBBR).

Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Breast Surgery

Background:

  • Implant-based breast reconstruction (IBBR) is a common global procedure.
  • Pre-pectoral IBBR offers aesthetic benefits and lower capsular contracture (CC) rates but isn't suitable for all patients.
  • Retropectoral IBBR remains a valuable option, though CC is a frequent complication, often requiring revision surgery.

Purpose of the Study:

  • To evaluate the efficacy of selective denervation of the pectoralis major muscle (PMM) in reducing complications in retropectoral IBBR.
  • To compare objective outcomes, including CC rates and implant malrotation, between denervated and non-denervated retropectoral IBBR groups.

Main Methods:

  • A retrospective comparison of patients undergoing denervated versus non-denervated retropectoral IBBR.
Keywords:
animation deformitycapsular contractureimplant malrotationimplant‐based breast reconstructionpectoralis major muscle denervationpre‐pectoral breast reconstructionretro‐pectoral breast reconstruction

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  • Objective evaluation of CC rates using the Baker scale and assessment of implant malrotation by independent breast cancer professionals.
  • Minimum 24-month follow-up period.

    • Main Results:

    • The overall mean follow-up was 3.33 years.
    • A significantly lower CC rate was observed in the denervated group (Group 1), even after propensity score adjustment.
    • Subjective patient outcomes were also positively impacted by PMM selective denervation.

    Conclusions:

    • Selective PMM denervation is a statistically appreciated technique by patients undergoing retropectoral IBBR.
    • This novel surgical approach significantly reduces the objective rate of capsular contracture in retropectoral IBBR.
    • PMM selective denervation offers improved outcomes for retropectoral implant-based breast reconstruction.