Short answer

Prioritize implant placement strategies that reduce anatomical disruption and associated patient morbidity, such as prepectoral placement, when designing or recommending breast reconstruction methods.

Field: Human Factors
Source: Frontiers in Oncology (2025)
Method: Retrospective comparative study
Sample: 136 participants
Evidence: Strong effect

Placing breast implants in a prepectoral position, rather than subpectorally, leads to significantly lower rates of wound infection, capsular contracture, and chest muscle pain, while maintaining comparable aesthetic satisfaction. This human factors research insight is drawn from a 2025 study published in Frontiers in Oncology. Using Retrospective comparative study with 136 participants, researchers explored how this design variable affects real-world outcomes. The key design takeaway: Prioritize implant placement strategies that reduce anatomical disruption and associated patient morbidity, such as prepectoral placement, when designing or recommending breast reconstruction methods.

Study

Human FactorsNew This WeekStrong effect

Prepectoral implant placement offers superior patient outcomes and reduced complications in breast reconstruction.

Frontiers in Oncology · 2025

Key Findings

01The prepectoral implant-based reconstruction (PIBR) group had significantly lower rates of wound infection, capsular contracture, and chest muscle pain compared to the subpectoral implant-based reconstruction (SIBR) group.
02Rates of wound dehiscence and implant wrinkling were statistically similar between PIBR and SIBR groups.
03BREAST-Q scores indicated similar patient satisfaction in terms of aesthetic outcomes between the groups.

Application

Design takeaway

How to apply

When considering breast reconstruction options, discuss the benefits of prepectoral placement with healthcare providers, focusing on reduced risks of infection, capsular contracture, and muscle pain.

Project actions

01When researching medical devices or procedures, consider the anatomical placement and its impact on user (patient) comfort and recovery.
02Investigate how different surgical approaches affect the body's response and healing process.

Method & Evidence

AimTo compare the clinical efficacy and aesthetic outcomes of prepectoral (single-incision, gas-inflated endoscopic prepectoral breast reconstruction - SIE-BR, and open prepectoral implant-based breast reconstruction - C-BR) versus subpectoral (open subpectoral implant-based breast reconstruction - SI-BR) implant-based breast reconstruction techniques.

MethodRetrospective comparative study

ProcedureClinicopathological data from 136 breast cancer patients who underwent different implant-based breast reconstruction techniques were analyzed. Outcomes including surgery time, blood loss, drainage volume, and complication rates (implant loss, flap necrosis, wound infection, capsular contracture, chest muscle pain, wound dehiscence, implant wrinkling) were compared. Patient satisfaction was assessed using the BREAST-Q questionnaire.

Sample136 participants

ContextBreast cancer treatment and reconstruction

Variables

IV["Implant placement approach (prepectoral vs. subpectoral)"]

DV["Wound infection rate","Capsular contracture rate","Chest muscle pain","Wound dehiscence rate","Implant wrinkling rate","BREAST-Q satisfaction scores"]

CV["Patient characteristics (e.g., age, BMI - assumed to be similar or accounted for in analysis)","Breast cancer diagnosis","Implant type (implied to be consistent within groups or broadly comparable)"]

Strengths & Limitations

Strengths

+Comparison of multiple surgical techniques.
+Inclusion of both objective clinical outcomes and subjective patient satisfaction measures.

Limitations

The study was conducted on a specific patient population and may not be generalizable to all individuals undergoing breast reconstruction. The specific surgical techniques within the prepectoral approach also showed some variation in outcomes.

Reliability & validity

The study's validity is supported by the use of objective clinical measures and a standardized patient satisfaction questionnaire. Reliability is enhanced by a relatively large sample size and a defined timeframe for data collection. However, the retrospective nature and potential for unmeasured confounding variables could affect reliability.

Think critically

While prepectoral placement shows advantages, what are the specific anatomical or patient factors that might still favor a subpectoral approach? How might future innovations bridge the gap or further enhance prepectoral techniques?

Design Principles

"Minimize tissue trauma and muscle involvement to improve patient recovery and reduce long-term complications in reconstructive procedures."

This finding has direct implications for surgical planning and patient care in breast reconstruction. Designers and medical device manufacturers can leverage this insight to develop and refine implant systems and surgical techniques that prioritize patient comfort and long-term well-being, potentially leading to improved quality of life post-treatment.

What This Means for Your Design

Putting the implant in front of the chest muscle (prepectoral) is better for patients after breast cancer surgery because it causes less pain, infection, and hardening of the implant compared to putting it behind the muscle (subpectoral).

How to use in your project

1.Use this study to justify the selection of a particular anatomical placement for a prosthetic or medical device in your design project, highlighting the benefits for the end-user.

Add to My Project

Quick Cite

Paragraph starter

The research by Zhang et al. (2025) indicates that prepectoral implant placement in breast reconstruction leads to significantly lower rates of complications such as wound infection, capsular contracture, and chest muscle pain compared to subpectoral placement, while achieving comparable aesthetic satisfaction. This suggests that designs prioritizing anatomical placement that minimizes muscle disruption can enhance patient outcomes and recovery.

Source

Frontiers in Oncology

Comparison of outcomes following prepectoral and subpectoral implants for breast reconstruction in patients with breast cancer

journal · 2025

View source

Questions About This Research

What does the research say about prepectoral implant placement offers superior patient outcomes and reduced complications in breast reconstruction?: Prioritize implant placement strategies that reduce anatomical disruption and associated patient morbidity, such as prepectoral placement, when designing or recommending breast reconstruction methods. Evidence: Frontiers in Oncology (2025).
Why does "Prepectoral implant placement offers superior patient outcomes and reduced complications in breast reconstruction." matter for design?: This finding has direct implications for surgical planning and patient care in breast reconstruction. Designers and medical device manufacturers can leverage this insight to develop and refine implant systems and surgical techniques that prioritize patient comfort and long-term well-being, potentially leading to improved quality of life post-treatment.
How can designers apply this research?: Prioritize implant placement strategies that reduce anatomical disruption and associated patient morbidity, such as prepectoral placement, when designing or recommending breast reconstruction methods.
What were the main findings?: The prepectoral implant-based reconstruction (PIBR) group had significantly lower rates of wound infection, capsular contracture, and chest muscle pain compared to the subpectoral implant-based reconstruction (SIBR) group.. Rates of wound dehiscence and implant wrinkling were statistically similar between PIBR and SIBR groups.. BREAST-Q scores indicated similar patient satisfaction in terms of aesthetic outcomes between the groups.
What research method was used?: Retrospective comparative study with 136 participants.
How strong is the evidence?: Evidence strength is rated Strong effect, based on a 2025 journal from Frontiers in Oncology.
What should I do differently in my next project?: When considering breast reconstruction options, discuss the benefits of prepectoral placement with healthcare providers, focusing on reduced risks of infection, capsular contracture, and muscle pain.
What are the limitations?: The study did not report on long-term outcomes beyond the immediate postoperative period, and potential differences in surgeon experience across the techniques were not explicitly controlled for.