Subcutaneous Reconstruction Without Acellular Dermal Matrix

The subpectoral method of expander/implant-based reconstruction after nipple-sparing mastectomy (NSM) is the most commonly practiced method of breast reconstruction. Latest reports of direct implant-based subcutaneous breast reconstruction with acellular dermal matrix or synthetic mesh have shown the suprapectoral approach to have distinct advantages related to breast shape and ease of reconstruction. We have used the subcutaneous method of expander/implant reconstruction without acellular dermal matrix for more than 10 years with results comparable to other methods. Here we present our experience with the suprapectoral staged technique of breast reconstruction and contrast it to submuscular reconstruction with acellular dermal matrix.