ABSTRACT
Breast reconstruction has become an integral part of breast cancer management in patients requiring a mastectomy. There are a wide variety of reconstruction techniques, although implant-based techniques are the commonest. This chapter focuses on the sub-muscular/sub-pectoral technique. There are five main stages to the sub-pectoral technique, namely patient selection; mastectomy; creation of a sub-pectoral space; placement of implant or expander in the sub-pectoral space; and creation of a new inferior pole. Nipple-sparing mastectomies in patients with a smaller breast size most commonly have an infra-mammary fold incision. Skin flap viability is essential in all breast reconstruction techniques. In a sub-pectoral reconstruction, infero-lateral tissue cover is deficient, and coverage is required. Acellular dermal matrices is the most common type of tissue/material used. In October 2016, the Health and Social Care Information Centre created a breast implant registry. This was developed in response to the Keogh Review of the regulation of cosmetic interventions.
