Mentor On-Demand Symposium: MOVE IT! SUBpec to PREpec Conversion-Mentor On-Demand Symposium: MOVE IT! SUBpec to PREpec Conversion Recording

Video Transcription

Video Summary

In this webinar, Dr. Brian Thornton, a board-certified plastic surgeon, shares his insights on transitioning breast reconstruction from the submuscular to the pre-pectoral space, which has been increasingly favored in recent years. Dr. Thornton discusses the advantages and considerations of this approach, emphasizing that pre-pectoral reconstruction can offer a more natural breast appearance and feel, reducing chronic pain and complications related to traditional submuscular methods. He outlines an algorithm to guide surgeons through the conversion process, from patient selection to technical execution.<br /><br />The presentation covers different aspects, such as patient types, complications, and specific surgical techniques, including dermis selection and implant choices. Dr. Thornton highlights the importance of using the inframammary fold incision to reduce complications and notes the need to adjust implant sizes when converting from a submuscular to a pre-pectoral placement to maintain the desired breast volume.<br /><br />He underscores the role of ADM (acellular dermal matrix) and fat grafting in improving outcomes, stating that careful handling of the tissue and understanding patient-specific needs are vital. The session addresses the complexities of managing patients with particular challenges, such as those with thin tissue envelopes or those who are smokers, obese, or diabetic.<br /><br />Dr. Thornton also shares practical advice on managing expectations and post-surgery follow-ups and explains the economic viability of pre-pec conversion with insights into CPT coding for billing. The session concludes with a Q&A segment, addressing further inquiries about fat grafting, implant wrinkling, and managing complex patient cases.

Keywords

breast reconstruction

pre-pectoral space

submuscular transition

natural breast appearance

surgical techniques

acellular dermal matrix

fat grafting

patient selection

implant choices

CPT coding