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Subpectoral VS Prepectoral Breast Reconstruction Surgery

Subpectoral vs Prepectoral Breast Reconstructive SurgeryThere are one of two ways that your breast reconstruction surgery will work the best for your body, Subpectoral (partially under the muscle placement) or Prepectoral Breast Reconstruction (over the muscle placement). Multiple factors play a role in determining the optimal implant placement for each individual patient, including patient health history, implant type, implant size, and the patient’s body type. To get a clear idea of what these opportunities and obstacles of Subpectoral vs. Prepectoral Breast Reconstruction Surgery, read on!

One in 8 women will develop breast cancer in her lifetime, and many of these women will undergo a mastectomy to remove one or both breasts followed by reconstruction. Whether you have been diagnosed with breast cancer or simply looking to feel more comfortable in your skin, breast reconstruction is a viable option for various individuals.

Subpectoral Breast Reconstruction Surgery

A traditional method of breast reconstruction surgery is Subpectoral, meaning the pectoralis major muscle is elevated from the chest wall so that a portion of the implant resides behind the muscle. This is a two-stage approach. First, a tissue expander is placed to reach the desired volume. Secondly, the patient is returned for an exchange of the tissue expander for the final breast implant, most commonly a silicone gel implant.


  • Has a more natural look as the implants are covered by both the breast tissue and the pectoral muscle.
  • Long-term reduction of wear to the skin because the muscle supports the placement of the implant.
  • Safer choice for those seeking a breast lift or those who may need a lift in the future as it preserves better blood flow to the nipple.
  • Reduced risk of visible rippling.
  • Less distortion of mammograms.


  • Surgical process is slightly more difficult and perceived as more “invasive”.
  • Longer recovery time mainly due to more post-op pain/discomfort.
  • Breasts may appear to sit a bit high until the muscle fully relaxes (about 4-6 weeks after surgery).
  • Implants can become distorted when the chest muscle is flexed.
  • Depending on the patient’s body type larger implants cannot be utilized.

Prepectoral Breast Reconstruction Surgery

A newer method of breast reconstruction is prepectoral reconstruction, where a plastic surgeon places the implant above the pectoralis major muscle, which is part of the chest and is located directly under a woman’s breast. Since an incision is not made in the muscle, the result leaves less pain and a more natural look because the breast implant is placed above the muscle and under the skin.


  • Surgical procedure is slightly easier and perceived as less invasive.
  • Lower recovery time and post-operative discomfort as the muscle stays intact.
  • Cleavage can be created because the implants can be placed slightly closer together.
  • Larger implants can be utilized depending on the soft tissue characteristics of the patient’s breasts.
  • Implants do not become distorted when the pectoral muscles are flexed.


  • Generally results in a less natural look where there is a pronounced roundness to the breast. This comes down to a personal preference, some women prefer this look.
  • Breasts are more susceptible to visible rippling as there is less tissue covering the implant along the upper border.
  • Creates mammogram distortion which requires more views to be taken.
  • The rates of capsule contracture tend to be higher.
  • Future or concurrent breast lift procedures become more risky with regard to maintaining blood flow to the nipple.

Subpectoral VS Prepectoral Breast Reconstruction Surgery

Whether you’re leaning in one direction or the other, talk with your doctor about both options, make sure you understand the procedures, their benefits and their drawbacks. Most importantly, you need to feel comfortable in your own body and taking the necessary steps to ensure you continue to maintain health and happiness is essential.

If you’re thinking about Subpectoral or Prepectoral Breast Reconstruction Surgery, start your journey with Dr. Finkel today!