What To Know About Prepectoral Implants After Mastectomy

The journey after a mastectomy is not just about physical healing — it’s about feeling whole again, reclaiming your body, and moving forward with confidence. Many women seek breast reconstruction not only to restore their appearance but also to regain a sense of normalcy and empowerment after breast cancer surgery. Prepectoral implants after a mastectomy are a modern approach to breast reconstruction and offer an innovative solution that has a shorter recovery time and enhances post-surgical comfort and aesthetics. 

Why Get Prepectoral Implants After Mastectomy?

Prepectoral implants represent a cutting-edge approach to breast reconstruction, where the implant is placed directly above the chest muscle rather than beneath it, as was the norm in years past. Traditionally, breast implants were inserted under the pectoralis muscle, a technique known as subpectoral implant placement; however, in recent years, many plastic surgeons have switched to a prepectoral placement, where implants rest on top of the muscle. Prepectoral implant placement offers a less invasive and potentially more comfortable option for women seeking to restore their breasts after a mastectomy.

Who Is a Good Candidate for Prepectoral Implants?

While prepectoral implants offer many advantages, they aren’t suitable for every patient. Women with good skin and tissue health post-mastectomy are typically ideal candidates, along with women who don’t need to undergo additional radiation therapy. 

Women who haven’t undergone radiation therapy or had low-dose radiation are better candidates because the radiation treatment required to eliminate cancerous cells can thin the overlying skin of the breast and compromise tissue health. If you need radiation therapy to treat your breast cancer, consult with your plastic surgeon about your best options. Prepectoral placement is not out of the question but might be more challenging due to potential complications like implant visibility or rippling. Adjunct fat grafting procedures can typically address these extra considerations by creating more volume around the upper pole of the breast.

Prepectoral implants are a particularly effective option for women undergoing prophylactic mastectomy with immediate reconstruction. Prophylactic mastectomy is a surgery where the breast tissue is removed before cancer is detected due to an increased risk of developing the disease in the future. During an immediate reconstruction, the implant can be placed directly above the chest muscle in a single surgery after the breast tissue has been removed. Consulting with a plastic surgeon early in your decision-making process will help you to determine if prepectoral placement is the best option for you based on your individual health, mastectomy needs, and long-term lifestyle and cosmetic goals.

The Prepectoral Implant Procedure and Recovery

Many women come to our office wanting to know more about the steps needed for their surgery. The process of getting prepectoral implants after mastectomy begins by removing the breast tissue. Depending on your diagnosis and needs, in consultation with your breast surgeon, oncologist, and plastic surgeon, you may opt for a total mastectomy, skin-sparing mastectomy, or nipple-sparing mastectomy.

If you undergo immediate direct-to-implant reconstruction after the mastectomy, the plastic surgeon places the implant below the skin and above the chest muscle, carefully placing it in its pocket. An acellular dermal matrix is often used to provide additional support and structure. An acellular dermal matrix acts like a biological scaffold, helping to integrate the implant with the surrounding tissue and ensure the long-term stability of the implant. 

If you need to undergo additional treatments for your breast cancer or need time to heal after the mastectomy before your reconstruction, the plastic surgeon will place tissue expanders that will maintain room for your future implants while your tissues heal from your mastectomy. These surgeries typically take a few hours, and depending on the case, patients may stay overnight in the hospital for monitoring.

Recovery from prepectoral implant surgery is generally smoother and less painful than traditional submuscular methods. Most patients can return to their normal routines within a few weeks, although some may need to take it easy for a bit longer, depending on the extent of the surgery and other health factors. Pain management tends to be straightforward, with many patients experiencing only mild discomfort. However, as with any surgery, there are risks, including infection, implant failure, or skin necrosis, although these complications are rare.

Harris Plastic Surgery – Experts at Prepectoral Implants After Mastectomy

Breast reconstruction is a deeply personal choice, and prepectoral implants offer an exciting option for women seeking comfort, a better range of motion, and a quicker recovery. If you’re considering this option, the professionals at Harris Plastic Surgery are here to help you determine if prepectoral implants are right for you and help coordinate all aspects of your breast surgery, reconstruction, and follow-up appointments. With our supportive staff and expert guidance, you can take control of your post-mastectomy journey with confidence.