The P1 Method: Prepectoral Breast Reconstruction to Minimize the Palpable Implant Edge and Upper Pole Rippling

Annals of Plastic Surgery
Troy A PittmanJames M Economides

Abstract

Prepectoral prosthetic-based breast reconstruction has become increasingly popular as an alternative to the partial or total submuscular approach. Potential issues with the prepectoral approach include a noticeable superior implant edge and implant rippling. These concerns are particularly apparent in thin patients. We introduce a novel muscle-sparing technique in which a partial-thickness slip of pectoralis muscle is created in an otherwise prepectoral plane to mask these upper pole defects, mask superior implant rippling, and provide greater implant support (The P1 Method). A retrospective review of all patients undergoing modified prepectoral (P1) breast reconstruction at a single institution over 2 years was undertaken. Data pertaining to patient demographics, mastectomy type/weight, reconstruction type, and esthetic and surgical outcomes were collected. Outcomes were analyzed using Fisher exact and Student t tests. Fifty patients (93 breasts) were identified during the study period. Mean final follow-up was 63 weeks (range, 53-85 weeks). Patients undergoing P1 reconstructions achieved improved esthetic results with less implant rippling and complete elimination of animation deformity seen on postoperative clinical images o...Continue Reading

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Citations

Aug 30, 2020·Aesthetic Plastic Surgery·Diego RibuffoAlessandro Scalise
Mar 19, 2019·Plastic and Reconstructive Surgery. Global Open·Elspeth J R Hill, Donald W Buck
Jan 19, 2019·Plastic and Reconstructive Surgery. Global Open·David E JanhoferDavid H Song
Sep 22, 2020·Plastic and Reconstructive Surgery·Azalia AvilaEleni A Tousimis
Apr 30, 2019·Plastic and Reconstructive Surgery·Anuja K Antony, Emilie C Robinson
Jun 28, 2019·Plastic and Reconstructive Surgery·Hani Sbitany, Kenneth R Lee
Jun 28, 2019·Plastic and Reconstructive Surgery·Maurice Y Nahabedian
Feb 8, 2020·Plastic and Reconstructive Surgery·Kassandra P NealonEric C Liao
Jan 28, 2020·Plastic and Reconstructive Surgery·Amy S Colwell, Erin M Taylor
Apr 26, 2020·Plastic and Reconstructive Surgery·Kassandra P NealonEric C Liao
May 8, 2021·Plastic and Reconstructive Surgery·Farah SayeghC Andrew Salzberg
May 24, 2021·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Dong Nyeok JeonHyun Ho Han

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