Sept. 29, 2026
๐ Can you do a prepectoral reconstruction without ADM or P4HB?
Dr. Adams brought that exact question to our expert panel on this episode of ๐๐ฝ๐: ๐ฝ๐ง๐๐๐จ๐ฉ ๐๐ข๐ฅ๐ก๐๐ฃ๐ฉ๐จ - Breast Reconstruction.
Dr. Nahabedian says yes, it's possible, and it may become more common as minimally invasive, robotic and endoscopic mastectomies grow, techniques where a small incision makes using ADM difficult in the first place. Early results are promising, with low rates of capsular contracture and malposition.
Dr. Rohrich raised a follow-up: if the mastectomy flaps are well vascularized, is a scaffold even necessary? Dr. Sigalove's answer: even well-perfused flaps benefit from what P4HB provides at a cellular level, upregulating anti-inflammatory and antimicrobial peptides that help guard against capsular contracture and infection. His take: skip the scaffold on poorly vascularized tissue, and the numbers will likely show it.
๐ฌ What do you think, would you want a scaffold used in your reconstruction? Let us know in the comments.
๐ฌ Watch the full conversation in Episode 10 now, link in our bio and stories, or right here ๐ https://youtu.be/j5vdUGUi6b4
#TBHBreastImplants #TBHEpisode10 #AestheticBreastReconstruction #PlasticSurgeryChannel #BreastReconstruction
Dr. Nahabedian says yes, it's possible, and it may become more common as minimally invasive, robotic and endoscopic mastectomies grow, techniques where a small incision makes using ADM difficult in the first place. Early results are promising, with low rates of capsular contracture and malposition.
Dr. Rohrich raised a follow-up: if the mastectomy flaps are well vascularized, is a scaffold even necessary? Dr. Sigalove's answer: even well-perfused flaps benefit from what P4HB provides at a cellular level, upregulating anti-inflammatory and antimicrobial peptides that help guard against capsular contracture and infection. His take: skip the scaffold on poorly vascularized tissue, and the numbers will likely show it.
๐ฌ What do you think, would you want a scaffold used in your reconstruction? Let us know in the comments.
๐ฌ Watch the full conversation in Episode 10 now, link in our bio and stories, or right here ๐ https://youtu.be/j5vdUGUi6b4
#TBHBreastImplants #TBHEpisode10 #AestheticBreastReconstruction #PlasticSurgeryChannel #BreastReconstruction
