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. 2020 Jan 24;10:1137. doi: 10.1038/s41598-020-58094-4

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© The Author(s) 2020

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Change in breast form following post-mastectomy radiation therapy (PMRT). Panels (A–C) depict implant positioning relative to pectoralis major muscle in subpectoral and prepectoral breast reconstruction in patients who did not undergo post-mastectomy radiation therapy (PMRT). Skeletal muscle fibrosis (panels D–F) is associated with PMRT and often results in the following clinical signs after subpectoral breast reconstruction: (I) superolateral displacement of nipple areolar complex, (II) dimpling or creasing of the soft tissue envelope at the level of the pectoralis major muscle, (III) flattening of inferior pole projection, and (IV) axillary fold crease.