Nipple-sparing mastectomy and direct-to-implant breast reconstruction with prepectoral implant placement

Nipple-sparing mastectomy (NSM) is replacing the conventional mastectomy in most patients. Immediate breast reconstruction is an integral part of this procedure. For the implant-based breast reconstruction generally the subpectoral implant placement is recommended. The advantage of a potentially better cosmetic result has to be balanced with the disadvantages, such as partial detachment of the pectoralis major muscle (PMM) with subsequent muscular deficit, breast animation and postoperative pain. Prepectoral implant placement and complete coverage with a porcine acellular dermal matrix (ADM) may provide an alter…