ArticlePlastic and reconstructive surgery2025
Prepectoral versus Submuscular Breast Reconstruction after Nipple-Sparing Mastectomy: Complications and Outcomes.
Article in Plastic and reconstructive surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Practice patterns in prepectoral implant-based breast reconstruction: A survey of UK plastic surgeons.JPRAS open · 2026Article
- A randomized controlled trial: application of inactivatedGland surgery · 2026Article
- Effectiveness of the Implementation of a Bundle Protocol for the Reduction of Postmastectomy Reconstruction Failures.Plastic and reconstructive surgery. Global open · 2026Article
- The current status and hot topics of endoscopic techniques in breast cancer surgery: a global bibliometric and visualization analysis (1999-2024).Gland surgery · 2026Article
- Hot Topics in Implant-Based Breast Reconstruction.Journal of clinical medicine · 2025Review
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Authors and funding
9 authors.
Funding
Abstract
backgroundPreprectoral breast reconstruction and nipple-sparing mastectomy (NSM) have both risen in popularity because of advances in reconstructive techniques. However, it is unknown whether exposed lactiferous ducts in an NSM may increase the risk for infection after prepectoral implant-based breast reconstruction. The authors aimed to assess complication rates and BREAST-Q physical well-being of the chest scores in patients who underwent NSM and implant-based breast reconstruction in a prepectoral versus submuscular plane.
methodsA retrospective review was performed of patients who underwent NSM with 2-stage implant-based reconstruction from 2013 to 2023. Patients were grouped by prepectoral or submuscular placement. Postoperative complications and BREAST-Q scores were assessed after surgery.
resultsA total of 693 patients were included: 345 underwent prepectoral and 348 underwent submuscular reconstruction. Surgical-site infection occurred in 10% of prepectoral patients and 5.7% of submuscular patients ( P = 0.03). Seroma occurred in 15% of prepectoral patients and 6.6% of submuscular patients ( P < 0.001). Multivariable analysis showed that prepectoral patients had significantly increased odds of developing surgical-site infection and seroma compared with submuscular patients (OR, 1.87; P = 0.04 and OR, 2.52; P < 0.001, respectively). However, prepectoral reconstruction was associated with significantly higher BREAST-Q physical well-being of the chest scores as compared with submuscular implant placement (β, 3.4; P = 0.01).
conclusionsPrepectoral reconstruction following NSM is associated with higher rates of surgical-site infection and seroma but improved physical well-being of the chest compared with submuscular implant placement following NSM. An increased risk of infection and seroma should be weighed against improved patient-reported outcomes when deciding on implant plane placement after NSM. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
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