Revisiting Prepectoral Breast Augmentation: Indications and Refinements

Abstract

Background: Prepectoral breast reconstruction is receiving renewed attention as a viable alternative to retropectoral reconstruction. Prepectoral breast augmentation needs to be reappraised, because patients increasingly demand safer and less invasive procedures with a shorter recovery period.

Objective: This study aimed to evaluate prepectoral breast augmentation combined with a microtextured prosthesis to determine whether it could be a useful alternative to retropectoral augmentation.

Methods: This study included 76 women (152 breasts) who were indicated for primary breast augmentation. The inclusion criterion was a pinch test result of more than 3 cm at the upper pole of the breast. A total subfascial dissection was performed with endoscopic assistance. Microtextured implants were placed through an axillary approach in the subfascial space.

Results: The mean follow-up period was 12 months (range, 6-23 months). The mean implant volume was 278.1 mL (range, 185-360 mL). Autologous fat grafts were applied in 12 patients. No patients developed seroma, capsular contracture, or malposition during the follow-up period. Two patients expressed concerns of minor contour visibility, but no patients required revisional surgery.

Conclusions: The drawbacks of prepectoral implant placement were sought to be managed by fascial coverage and microtextured prostheses. Although the follow-up duration was short, major complications were not encountered with Motiva Ergonomix SilkSurface implants. Therefore, prepectoral augmentation with microtextured prostheses should be reconsidered as a potential alternative to retropectoral methods because of the recent advances in surgical techniques and device technology.