A new way of rebuilding the breasts of women who have mastectomies is getting good reviews from patients. Shari Frontz, a patient who is also a nurse anesthetist at another hospital, had pre-pectoral reconstruction at MUSC Health. "I think the results look amazing. I’m very happy with the results," she says.

Dr. Ulm and patientInstead of putting the implant under the muscle, the surgeon places it over the muscle. Doctors say it's less painful and gets more natural-looking results than sub-pectoral reconstruction. It can be done immediately after a mastectomy, or, if the woman would prefer to wait, she can have the implants added later.

Pre-pectoral breast reconstruction has only been available in the U.S. for a few years, and it's still only done at select hospitals. MUSC Health is one of the first sites in the state to offer it. Plastic surgeons Kevin Delaney and Jason Ulm specialize in the procedure.

"Basically, it’s an option for almost anyone who is getting a mastectomy," Delaney says. "Most commonly that’s breast cancer, but it's also for women who are getting prophylactic mastectomies, if they have the BRCA gene, for example." BRCA genes raise the risk of breast cancer, and a mastectomy can reduce that risk.Dr. Ulm and Dr. Delaney

Pre-pectoral breast reconstruction is also an option for women who have had sub-pectoral breast reconstruction and are having problems with their implants. Ulm says the procedure can make a dramatic difference. "If everything goes as planned, the feel and shape and the way the breast looks are much improved. Much better."

He says pre-pectoral breast reconstruction is not safe for women who have had radiation because their blood flow is different and they have an increased risk of complications.