BREAST RECONSTRUCTION WITH PREPECTORAL IMPLANT

Immediate breast reconstruction direct to implant (DTI) is widely performed after mastectomy for both oncologic and risk-reduction purposes. Its oncologic safety is well established through large series, long follow-up, and robust meta-analyses and offers practical advantages. The optimal dissection plane for implant placement has been debated for decades, and prepectoral reconstruction (PP) has now re-emerged with the support of acellular dermal matrices (ADM), improved flaps, fat grafting, and high-er-quality implants. It avoids muscle dissection and deformation, enabling faster recovery, less pain, early return to activities, and easier execution, with complication rates comparable to retropectoral reconstruction (RP). Current evidence, however, still lacks randomized long-term studies.