In recent years, Pre-Pectoral Breast Reconstruction has emerged as an excellent technique for post-mastectomy reconstruction, as this technique spares the entire pectoralis major muscle, which is routinely detached from the ribs to cover the breast implant during the conventional submuscular technique. In this technique, there is function preservation of the pectoralis major muscle.  The silicone implant is positioned in front of the pectoral muscle, resulting in a reduction of both acute and chronic pain in the postoperative period. This technique is associated with less breast deformity during upper limb elevation, shorter surgical time and higher patient satisfaction.

 
Pre-pectoral breast reconstruction requires a rigorous patient selection, considering comorbidities, smoking, previous radiotherapy, subcutaneous thickness, skin viability and sagging. In addition to oncological criteria such as location and size of the breast tumor. Furthermore, it requires a mastologist's experience to make flaps with adequate, homogeneous skin thickness and with good perfusion during mastectomy, providing excellent coverage of the breast implant. As the pectoral muscles are spared, patients undergoing this technique can be discharged from the hospital in less than 24 hours, with reduced postoperative pain when compared to the standard technique with submuscular reconstruction and a faster return to the normal routine. 

In conclusion, Pre-Pectoral Breast Reconstruction shows a safe and promising technique with numerous benefits and with the same oncological safety as the conventional technique in selected patients with breast cancer.

Dr. Maximiliano Kneubil - CRM 36430
Mastology and Breast Reconstructive Surgery