Prepectoral Site Conversion for Animation Deformity

Background: A signifcant disadvantage of subpectoral breast reconstruction procedures is animation deformity during pectoralis major contraction. In this study, we discuss one surgeon's experience with elective subpectoral to prepectoral implant site conversion as a definitive solution to animation deformity.. Methods: Authors performed a retrospective review of pre-pectoral and sub-pectoral breast reconstructions performed by a single surgeon. Implants placed in the prepectoral plane were supported with total anterior AlloDerm coverage. Results: One hundred forty-two breasts in 90 patients who had underwent elective subpectoral to prepectoral implant site conversion. Postoperative resolution of animation deformity was 100%. Overall, complications are minimal with rates at 4.2% for infection, 2.1% for seroma, and 0.7% for hematoma, dehiscence, partial thickness necrosis, and explantation. One patient requested reoperation for reduction in implant volume. Baker grades II-IV capsular contractures are 0% at 43 months. Conclusion: Breast implant site conversion from the subpectoral to the prepectoral plane is a safe and definitive solution for animation deformity.