Implant Position
A prepectoral implant is placed above the pectoralis muscle and covered with biologic mesh, a subpectoral implant is placed below the pectoralis muscle with mesh covering it inferiorly.
In the past, the tissue expander and later the implant were routinely placed under the pectoralis muscle to provide an added layer of coverage (the subpectoral position). More recently, with the development of biologic mesh that can be used to cover the implant, it is commonly placed on top of the pectoralis muscle (a prepectoral position). This mesh material is also called acellular dermal matrix, is derived from cadaver skin, and becomes incorporated by the body over time.
The advantages of a prepectoral approach include less post-operative pain and elimination of “animation deformity,” or movement of a subpectorally placed implant when the pectoralis muscle is flexed.
A prepectoral implant is placed above the pectoralis muscle and covered with biologic mesh, a subpectoral implant is placed below the pectoralis muscle with mesh covering it inferiorly.