Table 1. Contraindications to prepectoral reconstruction.

Reconstructive	Oncologic
Thin flaps	Large tumors (>5 cm)
Poorly vascularized/ischemic flaps	Late cancer stage
History of prior radiation therapy (unless latissimus is used)	Deep tumors
BMI >40 kg/m2* immunocompromised HbA1c >7.5%	Chest wall involvement
Active smokers	Grossly positive axillary involvement
Lack fat donor sites	High risk of recurrence (based on multidisciplinary approach)

*, with other associated comorbidities (e.g., diabetes mellitus, hypertension). BMI, body mass index; HbA1c, hemoglobin A1c.