Resumen

Objectives: The objective of the prepectoral hybrid breast reconstructive technique is to overcome the disadvantages of retropectoral implant-based breast reconstructions. Additionally, an improved breast projection and firmness is provided with the insertion of an implant in the breast reconstructed with fat grafting. Introduction: Retropectoral implant-based breast reconstruction do not obtain the goals in breast surgery. The result is too often a breast that doesn't look natural, feels uncomfortable and cold with a breast that lacks dynamic ergonomics. The purpose of the hybrid approach is to reconstruct a breast that is more dynamic with a result that is stable at the long-term. Materials / method: The hybrid approach includes the usage of an expander that not only expands and preserves the skin envelope and footprint but also generates a vascularized capsule. This capsule is essential as it borders the space between the skin and the expander. This space can be augmented with serial sessions of fat grafting to reconstruct a prepectoral volume that adds a robust tissue coverage for a prepectoral implant. Results: Hybrid approaches result in more natural breasts that overcome the disadvantages of retropectoral implant-based breast reconstructions. Conclusion: The hybrid approach is a considerable alternative in breast reconstruction that overcomes the disadvantages of implant-based reconstructions as well as complete autologous tissue transfer with microsurgical techniques.