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PURPOSE: Multiple studies demonstrate that traditional submuscular tissue expander coverage offers the best protection against implant exposure but restricts lower pole expansion. Recognizing these limitations, the authors present a pectoralis major splitting approach for complete submuscular coverage in high-risk patients or those with ischemic mastectomy skin flaps. The pectoralis major muscle is split longitudinally along the direction of its fibers and submuscular pocket is developed elevating serratus muscle and anterior rectus fascia in continuity. The objective of this study was to evaluate expansion characteristics and complications using this technique.

Abstract P3. Pectoralis Major Splitting Approach in Immediate Breast Reconstruction: A Submuscular Tissue Expander Technique for High Risk Patients