Functional integrity of the shoulder joint and pectoralis major following subpectoral implant breast reconstruction

ABSTRACT Subpectoral implants for breast reconstruction after mastectomy requires the surgical disinsertion of the sternocostal fiber region of the pectoralis major. This technique is associated with significant shoulder strength and range of motion deficits, but it is unknown how it affects the underlying integrity of the shoulder joint or pectoralis major. The aim of this study was to characterize the long‐term effects of this reconstruction approach on shoulder joint stiffness and pectoralis major material properties. Robot‐assisted measures of shoulder strength and stiffness and ultrasound shear wave elastography images from the pectoralis major were acquired from 14 women an average of 549 days (range: 313–795 days) post reconstruction and 14 healthy, age‐matched controls. Subpectoral implant patients were significantly weaker in shoulder adduction (p