Prepectoral Breast Reconstruction

Prepectoral breast reconstruction has become a popular technique for postmastectomy breast reconstruction due to its numerous benefits. Pre -pectoral reconstruction provides the benefit of decreased acute and chronic pain, avoidance of animation deformity, improved upper extremity strength, high patient satisfaction, and esthetic outcomes. Preoperatively, patient selection is key to minimize the risk of postoperative compli-cations and optimize outcomes. Oncologic factors should be considered preoperatively to assess if the patient is a candidate for prepectoral recon-struction. Intraoperatively, mastectomy flap perfu-sion and viability assessment with clinical examination and perfusion devices are critical for successful reconstructive outcomes. ADM is used to re-establish natural breast borders, pro-vide long-term implant support and minimize capsular contracture. Fat grafting and proper implant selection can help minimize or prevent rippling. Reconstructive surgeons should critically assess preoperative patient characteristics and intraoperative surgical techniques to obtain optimal outcomes in prepectoral breast reconstruction.