I just saw a plastic surgeon who answered my question, so I thought I'd share in case anyone else is wondering about this. He said that subfascial placement is used in augmentation not reconstruction.

Hi meesha123, Legomaster is right, the technique is called Prepectoral Implant Reconstruction. It has been around for several years. I started a thread specifically dealing with that Reconstruction Technique called

Topic: TE/Implant OVER pectoral Can exercise, comfortable &NO RIPPLES!

It is often done with Alloderm, Stratice or SeriSilk Mesh, being wrapped around the implant, to cushion the implant under the skin, over the Pectoral Muscle. Often, additionally Fat Gafting is done to cover the implant edges. I had it done, along with several women who discuss their experiences and help each other, who are on the thread. I had Fat Grafting first, and then had the TE/Prepectoral Implant placed later. The implant edges cannot be seen, or felt for me, although other women did it the other way, TE/Implant first, then Fat Grafting. The recovery is much, much faster with the Prepectoral method versus Subpectoral. Also, my Pectoral was not cut or disturbed in any way, so I have almost full strength, which would be decreased for most women when an implant is placed under their pectoral muscle. I really believe it is the way of the future for Implant Reconstruction. I have the names of 40 Plastic Surgeon's across the US who are doing the Prepectoral Implant Reconstruction Method, listed on my Thread.

Come on by, and meet the wonderful women who are there.

Hi 123meesha, I was going to originally do a DIEP, then heard about Fat Grafting. I really hoped I would be lucky enough to reconstruct my breast with fat grafting alone. Unfortunately I had 2 severe infections after 2 of the fat grafting procedures and lost most of my grafted fat. I was especially vulnerable to those infections because of radiation fibrosis. I did manage to get enough fat to stay, to go from a Crater, to an "A Cup". Eventually I realized I would have to do either an implant of a flap procedure, if I ever wanted to look half normal again. So I found a new PS. I told him that because of the miserable tightness I was already experiencing due to the radiation fibrosis, that I couldn't imagine living with an implant stuffed under my pectoral muscle, that I only wanted the implant placed over my Pectoral . He agreed to do it, and then when he looked into it, found the research articles by a few of the pioneers of the Prepectoral Implant Reconstruction method. I was his first patient getting reconstructed by the Prepectoral method. He wrapped the implant in Seri Silk scaffolding. I can not see any animation defect, or the implant edges at all. I have a very nice looking cleavage, which makes me feel better about the whole miserable experience. I had alot of problems, exacerbated by the rad damage. I could have done things better, if I had better doctors to guide me through. Also if I had had enough money to get High Dose IV Vitamin C, I would have been able to skip those post op infections that caused me so much trouble. The antibiotics didn't work for me after a while, but when I broke into a retirement fund to pay for High Dose IV Vitamin C, after my TE and Implant exchange surgeries, I was able to reverse the infections and save my implant. Doctors should integrate helpful, safe treatments like HBOT, or IV Vitamin C, into the care women receive.