Compare the main approaches to breast reconstruction side by side — how each works, what supports the reconstruction, and where biological matrix and fat grafting fit. Select a pathway to explore, or switch to the comparison table.
The breast implant is placed above the pectoralis major muscle, in the subcutaneous plane, supported by a biological matrix rather than the muscle.
What it involves: A biological matrix (bovine pericardium or ADM) provides coverage and pocket support; often single-stage direct-to-implant. Fat grafting is frequently used to refine coverage.
The implant is placed partly or fully beneath the pectoralis major muscle, which is elevated to provide part of the coverage.
What it involves: The muscle is lifted and divided to form the pocket; may be combined with a matrix for lower-pole support. Often staged with a tissue expander.
The breast is rebuilt using the patient's own tissue (skin, fat, sometimes muscle) transferred from another part of the body — for example the abdomen or back.
What it involves: A longer, more complex microsurgical or pedicled operation with a donor site; no breast implant is required.
An implant-based reconstruction (often prepectoral) is combined with autologous fat grafting to add a layer of the patient's own tissue over the device.
What it involves: A biological matrix supports the implant, and fat grafting softens contours, improves coverage, and reduces visible rippling — especially in thin-flap patients.
Autologous fat grafting (lipofilling) transfers the patient's own processed fat to correct contour, rippling, or defects — used mainly as an adjunct, and as a primary approach only in selected cases.
What it involves: Fat is harvested by liposuction, processed, and reinjected. Volume retention depends heavily on the processing method used before reinjection.
| Approach | How it works | Muscle | Soft-tissue support | Where ABC fits |
|---|---|---|---|---|
| Implant-based — Prepectoral | The breast implant is placed above the pectoralis major muscle, in the subcutaneous plane, supported by a biological matrix rather than the muscle. | Muscle spared (left intact) | Biological matrix / ADM | ExaShape & PREPEC matrices + EXAFAT fat grafting |
| Implant-based — Subpectoral / Dual-plane | The implant is placed partly or fully beneath the pectoralis major muscle, which is elevated to provide part of the coverage. | Muscle elevated & divided | Muscle + optional matrix | Matrix support (ExaShape) where lower-pole reinforcement is used |
| Autologous — Flap Reconstruction | The breast is rebuilt using the patient's own tissue (skin, fat, sometimes muscle) transferred from another part of the body — for example the abdomen or back. | Depends on flap type | Patient's own tissue | Not implant/matrix-based — outside the ABC device platform |
| Hybrid — Implant + Fat Grafting | An implant-based reconstruction (often prepectoral) is combined with autologous fat grafting to add a layer of the patient's own tissue over the device. | Usually muscle-sparing | Biological matrix + autologous fat | ExaShape matrix + EXAFAT fat grafting (fat dialysis) |
| Fat Grafting (adjunct / selected cases) | Autologous fat grafting (lipofilling) transfers the patient's own processed fat to correct contour, rippling, or defects — used mainly as an adjunct, and as a primary approach only in selected cases. | Not applicable | Autologous fat only | EXAFAT closed-system fat grafting (fat dialysis) |
From the ExaShape® biological matrix for breast reconstruction to the EXAFAT® fat-grafting system — explore the full range of ABC devices.
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