Jumping Breast Phenomenon Following Subcutaneous Mastectomy: First Description and Grading of a Well-Known Breast Deformity

Introduction: One of the goals of breast cancer surgery is to preserve the breast. However, where this is not possible, various breast reconstructive procedures are available. The most common procedure is the immediate insertion of a subpectoral implant after removing the breast tissue. A significant challenge involving subpectoral implants is the deformation of the breast upon contraction of the pectoral muscle causing elevation of the breast and development of wrinkles or ripples in the caudal and cranial quadrants (jumping breast), especially in slim patients with a thin subcutaneous fat layer. Methods: While the jumping breast phenomenon after augmentation is well-known in cosmetic breast surgery, it has never been systematically described. In oncologic breast surgery, this deformity, which at times can be quite severe, has been ignored thus far. Results and Conclusion: In this paper, we present an initial distinction of grades for the so-called jumping breast, show examples for the different grades of severity of breast deformity in response to tensing of the pectoral muscle, and further describe different primary and secondary procedures for the prevention of the jumping breast phenomenon. By means of a 2-stage procedure, we can prevent this complication and reduce the risk of breast deformity after implant-based breast reconstruction.