The "Butterfly" Wrap: A Simplified Technique for Consistent Prosthesis Coverage in Prepectoral Breast Reconstruction

Background: Here, we describe our simple, systematic, reproducible, and effective method for prosthesis coverage in prepectoral breast reconstruction. Methods: Our Butterfly Wrap is a simple technique, which provides prosthesis coverage with a single sheet of acellular dermal matrix (ADM) in a reproducible and elegant manner. The wrap design creates an anatomic tear-shaped pocket to guide expansion and encourage lower pole fullness, without ADM folding or bunching for optimal incorporation and minimal overlap. Further, it minimizes waste, allowing for smaller sheets of ADM to be used per breast, and can easily be performed in minimal time on the back table while the mastectomies are being performed, as a means of minimizing cost. Results: Our technique can be applied to effectively cover all shapes and sizes of expanders and implants, both teardrop and round. As a result, the surgeon need only focus on the critical nuances of prosthesis-based prepectoral breast reconstruction, without the anxiety of how to wrap the prosthesis and what size of ADM to use. Conclusions: The Butterfly Wrap is a simple, systematic, reproducible, and effective method for prosthesis coverage in prepectoral reconstruction.