Prepectoral Reconstruction with Acellular Dermal Matrix (ADM) Strattice®

Abstract

The conventional mastectomies (modified radical mastectomy, simple mastectomy) are more and more replaced by conservative mastectomies (nipple-sparing mastectomy (NSM), skin-sparing mastectomy) without compromising the oncologic safety. Conservative mastectomies entail immediate autologous or heterologous breast reconstruction. For the implant-based breast reconstruction generally the subpectoral implant placement with a partial detachment of the pectoralis major muscle (PMM) is recommended. The advantage of a potentially better cosmetic result faces the disadvantages, such as partial dissection of the PMM with subsequent muscular deficit, breast animation deformity, and postoperative pain. Prepectoral implant placement and complete coverage of the implant with an acellular dermal matrix (ADM) could be an alternative and is described in this chapter.