Implant-Based Breast Reconstruction

Implant-based breast reconstruction following mastectomy involves insertion of a breast implant on top of or beneath the pectoral muscles in the chest. It is typically a shorter and less complex procedure than autologous reconstruction, and you are under general anesthesia for less time. Additionally, this option does not require operating on another part of your body to collect the “donor tissue,” as an autologous procedure does. This means you would have a scar only in the breast area. Finally, with an implant, when you gain or lose weight, your breast will not change size or shape. At Mount Sinai West, in select patients, we can perform implant-based breast reconstruction as an outpatient procedure, with no overnight stay.

There are various methods of breast reconstruction with implants. Most of these procedures insert the implant under the pectoralis major muscle. At Mount Sinai West, we have special expertise in a procedure called prepectoral breast reconstruction. This groundbreaking muscle-sparing procedure places the breast implant above the chest wall muscles, leaving the pectoral muscles preserved and intact without any cutting or stretching. This results in less postoperative pain and a faster recovery, and no future loss of strength.

Prepectoral Breast Reconstruction

Some women facing a mastectomy want to have their breasts reconstructed using an implant. If this is your preference, the latest and most advanced technique, called prepectoral breast reconstruction, is available at Mount Sinai West, one of the few hospitals in the country routinely offering this option. Prepectoral breast reconstruction surgery is a specialized procedure performed by a select group of specialists. Our director, Hani Sbitany, MD, at Mount Sinai West is an internationally recognized expert who helped pioneer this groundbreaking technique.

For years, doctors have placed implants beneath the pectoralis major muscles, as an extra layer of protection and coverage. The disadvantage of this technique is that it requires separating the muscles from the ribs and stretching them permanently so they can accommodate the implants. This process can weaken the muscle permanently, often causing pain, diminished function, and breast deformities when the chest muscles are flexed (hyperanimation).

Prepectoral (muscle-sparing) breast reconstruction avoids these permanent side effects by completely preserving the pectoralis muscle in its natural position, and placing the implants above the muscle. The procedure uses a sheet of collagen, the structural protein found in skin and other tissues, to act as scaffolding, wrapped around the implant, and permits the surgeon to place the implant right beneath the skin, on top of the muscle, without disturbing it. This minimally invasive procedure is just as successful as traditional implant reconstruction but with numerous additional benefits, such as:

  • Shorter overall treatment and recovery time
  • Decreased postsurgical pain
  • Full muscle function and strength

Because it eliminates the need to cut into muscle, the prepectoral breast reconstruction procedure is also faster than traditional implant surgery, and it is easier to perform revision procedures if needed. Prepectoral breast reconstruction is appropriate for any woman who chooses to reconstruct her breasts with an implant after mastectomy, and is routinely performed at Mount Sinai West.