Abstract: Fat Grafting Prior to Tissue Expander Exchange Can Optimize Results in Implant- Based Reconstruction in Irradiated Breast

INTRODUCTION: Pre-pectoral direct to implant (DTI) breast reconstruction has historically been fraught with complications including flap necrosis, implant extrusion, and capsular contracture as well as extremely high rates of operative revisions. This may result from a number of factors, including the lack of an algorithmic approach, failure to predict postoperative migration of the implant, use of improper implants, and unsuitable patient selection. Over the last 5 years, we have gained significant experience from the performance of DTI reconstructions at our institution and believe we have valuable knowledge and clinical pearls to offer to reconstructive surgeons.