title: Prepectoral Implant-Based Breast Reconstruction: Rationale, Indications, and Preliminary Results.
abstract: Implant-based breast reconstruction is currently performed with placement of the implant in a subpectoral pocket beneath the pectoralis major muscle, by means of the dual-plane approach. Although the safety and breast aesthetics of this approach are well recognized, it is not without concerns. Animation deformities and accompanying patient discomfort, which are direct consequences of muscle elevation, can be severe in some patients. Moving the implant prepectorally may eliminate these concerns. For a successful prepectoral approach, the authors advocate use of their bioengineered breast concept, which was detailed in a previous publication. In this report, the authors discuss the rationale for prepectoral implant reconstruction, its indications/contraindications, and preliminary results from over 350 reconstructions.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Winfield, Ill.; Loma Linda, Calif.; Portland, Ore.; and Vancouver, Wash.|From the DuPage Medical Group/DMG Aesthetics; the Departments of Plastic Surgery and Breast Surgery, Central DuPage Hospital/Northwestern Medicine; the Department of Plastic Surgery, Loma Linda University Medical Center; the Breast Program, Compass Oncology; and the Peace-Health Medical Group Plastic Surgery.
authors.forename: Steven
authors.initials: S
authors.lastname: Sigalove
authors.affiliation: Winfield, Ill.; Loma Linda, Calif.; Portland, Ore.; and Vancouver, Wash.|From the DuPage Medical Group/DMG Aesthetics; the Departments of Plastic Surgery and Breast Surgery, Central DuPage Hospital/Northwestern Medicine; the Department of Plastic Surgery, Loma Linda University Medical Center; the Breast Program, Compass Oncology; and the Peace-Health Medical Group Plastic Surgery.
authors.forename: G Patrick
authors.initials: GP
authors.lastname: Maxwell
authors.affiliation: Winfield, Ill.; Loma Linda, Calif.; Portland, Ore.; and Vancouver, Wash.|From the DuPage Medical Group/DMG Aesthetics; the Departments of Plastic Surgery and Breast Surgery, Central DuPage Hospital/Northwestern Medicine; the Department of Plastic Surgery, Loma Linda University Medical Center; the Breast Program, Compass Oncology; and the Peace-Health Medical Group Plastic Surgery.
authors.forename: Noemi M
authors.initials: NM
authors.lastname: Sigalove
authors.affiliation: Winfield, Ill.; Loma Linda, Calif.; Portland, Ore.; and Vancouver, Wash.|From the DuPage Medical Group/DMG Aesthetics; the Departments of Plastic Surgery and Breast Surgery, Central DuPage Hospital/Northwestern Medicine; the Department of Plastic Surgery, Loma Linda University Medical Center; the Breast Program, Compass Oncology; and the Peace-Health Medical Group Plastic Surgery.
authors.forename: Toni L
authors.initials: TL
authors.lastname: Storm-Dickerson
authors.affiliation: Winfield, Ill.; Loma Linda, Calif.; Portland, Ore.; and Vancouver, Wash.|From the DuPage Medical Group/DMG Aesthetics; the Departments of Plastic Surgery and Breast Surgery, Central DuPage Hospital/Northwestern Medicine; the Department of Plastic Surgery, Loma Linda University Medical Center; the Breast Program, Compass Oncology; and the Peace-Health Medical Group Plastic Surgery.
authors.forename: Nicole
authors.initials: N
authors.lastname: Pope
authors.affiliation: Winfield, Ill.; Loma Linda, Calif.; Portland, Ore.; and Vancouver, Wash.|From the DuPage Medical Group/DMG Aesthetics; the Departments of Plastic Surgery and Breast Surgery, Central DuPage Hospital/Northwestern Medicine; the Department of Plastic Surgery, Loma Linda University Medical Center; the Breast Program, Compass Oncology; and the Peace-Health Medical Group Plastic Surgery.
authors.forename: Jami
authors.initials: J
authors.lastname: Rice
authors.affiliation: Winfield, Ill.; Loma Linda, Calif.; Portland, Ore.; and Vancouver, Wash.|From the DuPage Medical Group/DMG Aesthetics; the Departments of Plastic Surgery and Breast Surgery, Central DuPage Hospital/Northwestern Medicine; the Department of Plastic Surgery, Loma Linda University Medical Center; the Breast Program, Compass Oncology; and the Peace-Health Medical Group Plastic Surgery.
authors.forename: Allen
authors.initials: A
authors.lastname: Gabriel
mesh_terms: D000328:Adult; D000368:Aged; D019928:Breast Implantation / Q000379:methods*; D018427:Breast Implants; D000075202:Contraindications; D005260:Female; D006801:Humans; D008875:Middle Aged; D010369:Pectoralis Muscles; D017410:Practice Guidelines as Topic; D055815:Young Adult