Surgical technique: submuscular placement of breast implant ports with delayed expansion following ultrasound localization.

Immediate or delayed reconstruction is offered to most women after mastectomy as standard care in the UK. Many women choose breast reconstruction with an implant alone or in conjunction with a myocutaneous flap. The most recent generation of biodimensional anatomical permanent expanders has permanent ports for delayed saline inflation. In slim women, the subcutaneous placement of the port and tubing may be unsightly and cause symptoms of pain and chaffing. We describe a technique of inserting the permanent port deep to a muscular layer on the chest wall to avoid these problems. This technique has been used in five satisfied patients, with a mean body mass index of 24.0 (range 21.7-25.5) kg/m(2). The mean follow-up was 9.4 (range 5-14) months with no complications or problems. The port placement technique we describe is effective and facilitates permanent implantation for long-term access.