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1329 Cherry Way Dr, Suite 700,
Gahanna, OH 43230, USA


Prepectoral breast reconstruction is a procedure that uses tissue expander and implants to slowly recreate the breasts after mastectomy surgery. After a mastectomy, the skin may be left sagging and by increasing the amount of saline in the implant, it can be easily adjusted to your preferred size and shape with minimal excess skin. The procedure is ideal for patients who still need to undergo chemotherapy or radiation therapy. Unlike subpectoral implants, the chest muscles are not harmed, leaving them less vulnerable to further radiation damage.

Leading board-certified plastic surgeons, Dr. Panjak Tiwari, Dr. Ergun Kocak and Dr. Santosh Kale have provided thousands of women in Ohio and beyond with beautiful and life-changing results from prepectoral breast reconstruction surgery.

Insurance Coverage and Cost

The total costs for a prepectoral breast reconstruction are covered by insurance under the Women’s Health and Cancer Rights Act of 1998.

Contact our team online or at +1 855-687-6227 to set up an appointment with one of our doctors in Columbus, Ohio.

The Prepectoral Reconstruction Procedure

Prepectoral reconstruction is an outpatient procedure, but the final result requires multiple return visits to your physician. You will be under general anesthesia for this operation, and the insertion of the tissue expander takes 1 – 2 hours immediately after mastectomy. You will wake up with an empty expander supported by an acellular dermal matrix to protect it from exposure.

Please follow post-mastectomy recovery instructions after this.

A saline solution will be used to fill the expander after 2 weeks, or after the mastectomy wounds heal. This will repeat every 1 – 2 weeks until blood vessels grow on the dermal matrix, and the desired breast size and shape is attained.

After a month, the old incision will be opened and the expander removed. It is replaced by permanent saline or silicone gel implant.

Recovery & Results

There are ways to make the recovery process for prepectoral reconstruction safe, fast, and yield the results you truly desire. Have a friend or family member help you with your activities for 1 week, after which you can return to work.

You may shower after 24 hours, but avoid soaking your breasts in water until cleared by your doctor. Mild swelling and bruising may occur and will disappear after 4 weeks, during which you can resume strenuous activities, chores, exercise, and driving.

There may be some risks and complications, including:

  • Decrease or Loss of Nipple Sensation – Due to the failure of the formation of blood vessels on the dermal matrix
  • Implant Infections – Due to carless wound management
  • Implant Rupture – A rare occurrence but can happen long after the initial surgery


"Dr Tiwari Thanks for being one of the good guys I pray God blesses you and your family for blessing others I know I will be sending other women with BII your way PS your staff rocks too..."
"Hi Dr Kocak I just wanted to say thank you for putting this broken girl back together Youve always been so kind and patient with me - and always enjoy your sense of humor Thank you for coming to Marietta and taking great care of me You and Tiwari were the best - the staff still talks about ..."
"Dr Tiwari Thanks for the tip on using Cayenne Id love to have the literature on that because Ill put it on my blog May help someone else too..."
"Dr Tiwari - So I researched for months interviewed 4 surgeons before I watched on of your on-line videos thought at the time the idea of traveling so far seemed extreme to have surgery after talking to you over the phone for the first time my mind was at east about all of it and I ..."
"After being diagnosed with Breast Cancer for the third time I underwent a double mastectomy and unfortunately developed lymphedema in my arm This complication was due to the fact that I had 12-13 lymph nodes removed the second time I had breast cancer The swelling in my arm was so bad I was ..."

Frequently Asked Questions

What is an acellular dermal matrix?

An engineered sheet of tissue often taken from a cadaver. This device will slowly become a natural part of your body, growing new tissue including blood vessels and cells.

If I previously had an implant reconstruction, can I have redo or revision surgery to convert it to a prepectoral reconstruction?

Yes. It is possible to reposition the implant to the prepectoral position for unwanted animation deformity (a deformity of the breast with contraction of the pectoralis major muscle) or an undesired aesthetic outcome. This will process will take approximately 3 months.

Can I undergo a pre-pectoral reconstruction without the need for a tissue expander? (DTI: Direct-to-Implant technique)

As one of the many reconstructive techniques, it is possible to place the implant beneath the skin and above the chest muscles. This would negate the need for the tissue expander during surgery. The skin above the implant must be in excellent health and a smaller implant must be utilized in order to reduce the stress on the area. The downside to this technique would be the risk of infection and implant exposure. Additionally, replacement rates are significantly higher.

Request Your Consultation

To learn more about pre-pectoral reconstruction, you can schedule an appointment online or you can call 855-687-6227

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*The information available on this page was created to educate our patients. It is not an alternative for a formal consultation with a board-certified plastic and reconstructive surgeon. Individual results vary per patient. For more information, we strongly recommend scheduling a consultation with our doctors.