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. 2019 Jul 29;7(7):e2301.
doi: 10.1097/GOX.0000000000002301. eCollection 2019 Jul.

Prepectoral Site Conversion for Animation Deformity

Glyn E Jones  1 , Victor A King  2 , Aran Yoo  3
Affiliations

Prepectoral Site Conversion for Animation Deformity

Glyn E Jones et al. Plast Reconstr Surg Glob Open. .

Abstract

A signifcant disadvantage of subpectoral breast reconstruction procedures is animation deformity during pectoralis major contraction. In this study, we discuss one surgeon's experience with elective subpectoral to prepectoral implant site conversion as a definitive solution to animation deformity..

Methods: Authors performed a retrospective review of pre-pectoral and sub-pectoral breast reconstructions performed by a single surgeon. Implants placed in the prepectoral plane were supported with total anterior AlloDerm coverage.

Results: One hundred forty-two breasts in 90 patients who had underwent elective subpectoral to prepectoral implant site conversion. Postoperative resolution of animation deformity was 100%. Overall, complications are minimal with rates at 4.2% for infection, 2.1% for seroma, and 0.7% for hematoma, dehiscence, partial thickness necrosis, and explantation. One patient requested reoperation for reduction in implant volume. Baker grades II-IV capsular contractures are 0% at 43 months.

Conclusion: Breast implant site conversion from the subpectoral to the prepectoral plane is a safe and definitive solution for animation deformity.

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Figures

Fig. 1.
Fig. 1.
The pectoralis major muscle returned to the chest wall, creating a prepectoral pocket for implant placement.
Fig. 2.
Fig. 2.
Shaping of the ADM to control pocket shape and dimensions.
Fig. 3.
Fig. 3.
A, Sixty-year-old woman with prior radiated left subpectoral breast reconstruction with animation and asymmetry secondary to radiation fibrosis. B, Postoperative view of the patient following left prepectoral conversion with ADM insertion and implant upsizing.
Fig. 4.
Fig. 4.
A, Fifty-five–year-old woman with radiated left subpectoral 2 stage expander implant reconstruction with animation and asymmetry secondary to radiation fibrosis and stable right subpectoral breast augmentation. B, Postoperative view of the patient following left prepectoral conversion with ADM insertion and implant upsizing.
Fig. 5.
Fig. 5.
A, Fifty-seven–yr-old woman following right 2 stage subpectoral expander implant reconstruction 10 years previously with right mastopexy augmentation. She complained of asymmetry and animation with daily discomfort. B, Postoperative view of the patient following right prepectoral conversion with ADM insertion and implant upsizing and revisionary left mastopexy–augmentation.
See this image and copyright information in PMC

References

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