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Hani Sbitany, MD
Chief of Plastic & Reconstructive surgery
Specialist in Breast REconstruction Surgery
Mt Sinai West Medical Center
New York City
prepectoral breast reconstruction
Left Mastectomy and Prepectoral Implant Reconstruction
Implant-based breast reconstruction has been the most common method used for years in the United States, for women undergoing mastectomy. The traditional location for surgical placement of implants has been the area underneath the pectoralis major muscle on the chest. This "subpectoral" placement of implants, has been performed with the thought that wrapping the implant with the pectoralis muscle will stabilize the implant.
However, there are downsides to patients resulting from dissecting, stretching, cutting, and wrapping the pectoralis major muscle, to achieve "subpectoral" implant placement. These downsides include higher incidence of chronic pain, loss of strength, unnatural feel, and muscle tightness. Furthermore, there is a high risk of "animation deformity" of the reconstructed breasts.
Dr. Sbitany, along with some of his colleagues around the United States, has helped define and pioneer the procedure of "Prepectoral" breast reconstruction. In this procedure, the implant is placed in front of the pectoralis major muscle. As such, the muscle is never dissected or disturbed, and the implant is placed in the same anatomic location as the previous breast tissue (prior to mastectomy) thus resulting in a more natural appearance and feel.
Dr. Sbitany is able to safely place implants in this location due to the use of biologic scaffolds to instead support and stabilize the implant. This procedure has gained worldwide interest and adoption among plastic surgeons, due in large part to Dr. Sbitany's publications and speaking appearances around the globe.
The benefit to patients from having prepectoral breast reconstruction is significant. Studies show that narcotic use after surgery is up to 75% less, as pain is reduced significantly. Furthermore, there is no risk of animation deformity.
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