Over the Muscle Breast Reconstruction

Thank you for your question. The answer ultimately depends on your plastic surgeon's experience and preference. As a general statement, the state-of-the-art allows for pre-pectoral (above the muscle) direct to implant or expander placement int he immediate setting with coverage using ADM (acellular dermal matrix). In a thin patient there is a risk of the implant edge being more visible or apparent, and this can be corrected with future revision surgery using your own fat, known as "autologous fat injection" or "grafting",

Please make sure that your plastic surgeon is well versed in all breast reconstruction techniques and discuss all of your options with him or her. Best of luck to you.

I routinely do pre -pectoral breast recnstruction
If the flaps re thin I thicken them with fat grafting or mesh

Depends on your skin condition after mastectomy, if your skin is thin but healty and well vascularised after mastectomy, yes prepec reconstruction can be done. But you may need a fat transfer procedure after six months to cover the visible parts of the implant