Prepectoral Implant for Immediate Breast Reconstruction after Mastectomy: A Review Article

Breast cancer is the most common malignancy among women, with 2.3 million new cases diagnosed annually. Immediate breast reconstruction has become integral to patient-centered care. Prepectoral implant placement is re-emerging as a promising alternative to submuscular techniques, offering reduced postoperative pain, quicker recovery, and improved aesthetics. A narrative review of published literature was conducted, focusing on the evolution of implant placement, patient selection, surgical technique, outcomes, and complications. Special attention was given to the role of acellular dermal matrix (ADM) and the practical challenges faced in low- and middle-income countries (LMICs). Prepectoral reconstruction avoids muscle dissection, reducing pain, dysfunction, and animation deformity. Use of ADM lowers capsular contracture but increases costs and infection risk. Reported complications include seroma, rippling, and flap necrosis. While long-term comparative studies remain limited, evidence supports safe outcomes in selected patients. In LMICs, alternatives to ADM and reliance on clinical flap assessment make the approach feasible despite resource constraints. Prepectoral implant-based reconstruction is an evolving technique with clear functional and aesthetic benefits. Adaptation to local resources allows wider applicability, though further long-term data are needed to optimize oncologic safety and patient satisfaction.