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Current Advances in Breast Reconstruction
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Current Advances in Breast Reconstruction

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Plastic, Reconstructive and Aesthetic Surgery/Aesthetic Medicine".

Deadline for manuscript submissions: closed (25 July 2023) | Viewed by 11897

Special Issue Editor

Prof. Dr. Warren M Rozen

E-Mail Website
Guest Editor
Department of Plastic, Reconstructive and Hand Surgery, Peninsula Campus, Central Clinical School, Monash University, Frankston, VIC 3199, Australia
Interests: breast reconstruction; reconstructive microsurgery; surgical anatomy; reconstructive surgery; microvascular imaging
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

I am excited to compile a Special Issue on updates and advances in breast reconstruction, and I hope this will serve as a go-to edition for a range of exciting topics that are on the horizon.

The aim of this edition will be to include an international breadth of clinicians and researchers, and a breadth of topics, including clinical aspects of autologous and alloplastic reconstruction, the effect of oncologic advances on breast reconstruction, and basic science advances in oncology, tissue transfer, and alloplastic devices.

I hope that your expertise can help to provide readers with the current state of the art.

Prof. Dr. Warren M Rozen
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • breast reconstruction
  • reconstructive microsurgery
  • surgical anatomy
  • reconstructive surgery
  • microvascular imaging

Published Papers (5 papers)

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Editorial

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4 pages, 198 KiB  
Editorial
Current Advances in Breast Reconstruction
by Jevan Cevik, David J. Hunter-Smith and Warren M. Rozen
J. Clin. Med. 2022, 11(12), 3328; https://doi.org/10.3390/jcm11123328 - 10 Jun 2022
Cited by 6 | Viewed by 1393
Abstract
Breast cancer management is multidisciplinary, and while oncologic surgery, adjuvant therapy, and psychological therapies are central to this, breast reconstruction also forms an integral part of management [...] Full article
(This article belongs to the Special Issue Current Advances in Breast Reconstruction)

Research

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14 pages, 3815 KiB  
Article
Mastopexy Strategies for Ptotic Breasts in Patients Choosing Autologous Reconstruction Following Prophylactic Mastectomy
by Charalampos Varnava, Miriam Bogusch, Sascha Wellenbrock, Tobias Hirsch, Philipp Wiebringhaus and Maximilian Kueckelhaus
J. Clin. Med. 2023, 12(9), 3082; https://doi.org/10.3390/jcm12093082 - 24 Apr 2023
Viewed by 2790
Abstract
Background: Autologous breast reconstruction is a reliable solution for many patients after mastectomy. While this technique represents a standardized approach in many patients, patients with ptotic breasts may require a combination of procedures to achieve an aesthetically pleasing result. Methods: We reviewed the [...] Read more.
Background: Autologous breast reconstruction is a reliable solution for many patients after mastectomy. While this technique represents a standardized approach in many patients, patients with ptotic breasts may require a combination of procedures to achieve an aesthetically pleasing result. Methods: We reviewed the mastectomy and free-flap breast reconstruction procedures performed at our institution from 2018 to 2022 in patients with ptotic breasts. The technique used to address the ptosis was put in focus as we present the four strategies used by our reconstructive surgeons. We performed two different one-stage and two different two-stage procedures. The difference between the two-stage procedures was the way the nipple areola complex was treated (inferior dermal pedicle or free skin graft). The difference between the one-stage procedures was the time of execution of the mastopexy/breast reduction (before or after the mastectomy and autologous breast reconstruction). Results: The one-stage procedure was performed with a free NAC in three patients and with a pedicled NAC in five patients. The two-stage procedure was performed in seven patients, with six of them undergoing mastopexy before and one patient undergoing mastopexy after the bilateral mastectomy and autologous reconstruction. No flap loss or total loss of the nipple areola complex occurred. Partial NAC loss was observed in five breasts in the single-stage group without any occurrence in the double-stage group. Conclusions: While both one- and two-stage procedures were performed in a safe fashion with satisfactory results at our institution, larger trials are required to determine which procedure may yield the best possible outcomes. These outcomes should also include oncological safety and patient-reported outcomes. Full article
(This article belongs to the Special Issue Current Advances in Breast Reconstruction)
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10 pages, 856 KiB  
Article
Sub-Muscular Direct-to-Implant Immediate Breast Reconstruction in Previously Irradiated Patients Avoiding the Use of ADM: A Preliminary Study
by Lucrezia Pacchioni, Gianluca Sapino, Irene Laura Lusetti, Giovanna Zaccaria, Pietro G. Di Summa and Giorgio De Santis
J. Clin. Med. 2022, 11(19), 5856; https://doi.org/10.3390/jcm11195856 - 3 Oct 2022
Cited by 1 | Viewed by 3987
Abstract
Background: The aim of this paper is to present a preliminary experience of sub-muscular primary direct-to-implant (DTI) breast reconstruction without acellular dermal matrix (ADM), after salvage mastectomy for local recurrence following prior irradiation. Methods: A retrospective investigation was performed on a prospectively maintained [...] Read more.
Background: The aim of this paper is to present a preliminary experience of sub-muscular primary direct-to-implant (DTI) breast reconstruction without acellular dermal matrix (ADM), after salvage mastectomy for local recurrence following prior irradiation. Methods: A retrospective investigation was performed on a prospectively maintained database of breast reconstruction cases at our institution between January 2015 and December 2020. We considered only immediate DTI breast reconstructions without ADM following radiotherapy and salvage mastectomy for local recurrence, with at least a 12-month follow-up. Results: The study considered 18 female patients with an average of 68 years. According to the BREAST-Q questionnaire, all patients reported high levels of “satisfaction with outcome” with good “psychosocial wellness” and “physical impact” related to the reconstruction. The aesthetic evaluation showed a significant difference between the VAS score gave by the patient (mean 6.9) and the surgeon (mean 5.4). No implant exposure occurred in this series. In terms of complications, four patients (22%) suffered from wound dehiscence and were managed conservatively. Three patients (17%) required primary closure in day surgery following superficial mastectomy flap necrosis. Late capsular contracture was seen in seven patients (four Baker stage II and three Baker stage III, totally 39%); however, no patient was willing to undergo implant exchange. Conclusions: DTI breast reconstruction following prior irradiation can be considered as an option in patients who are not good candidates for autologous breast reconstruction. Our general outcomes compared favorably with literature data regarding the use of staged procedures, with acceptable complication rates and levels of patient satisfaction. Full article
(This article belongs to the Special Issue Current Advances in Breast Reconstruction)
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Review

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14 pages, 2128 KiB  
Review
A History of Innovation: Tracing the Evolution of Imaging Modalities for the Preoperative Planning of Microsurgical Breast Reconstruction
by Jevan Cevik, Ishith Seth, David J. Hunter-Smith and Warren M. Rozen
J. Clin. Med. 2023, 12(16), 5246; https://doi.org/10.3390/jcm12165246 - 11 Aug 2023
Cited by 2 | Viewed by 1263
Abstract
Breast reconstruction is an essential component in the multidisciplinary management of breast cancer patients. Over the years, preoperative planning has played a pivotal role in assisting surgeons in planning operative decisions prior to the day of surgery. The evolution of preoperative planning can [...] Read more.
Breast reconstruction is an essential component in the multidisciplinary management of breast cancer patients. Over the years, preoperative planning has played a pivotal role in assisting surgeons in planning operative decisions prior to the day of surgery. The evolution of preoperative planning can be traced back to the introduction of modalities such as ultrasound and colour duplex ultrasonography, enabling surgeons to evaluate the donor site’s vasculature and thereby plan operations more accurately. However, the limitations of these techniques paved the way for the implementation of modern three-dimensional imaging technologies. With the advancements in 3D imaging, including computed tomography and magnetic resonance imaging, surgeons gained the ability to obtain detailed anatomical information. Moreover, numerous adjuncts have been developed to aid in the planning process. The integration of 3D-printing technologies has made significant contributions, enabling surgeons to create complex haptic models of the underlying anatomy. Direct infrared thermography provides a non-invasive, visual assessment of abdominal wall vascular physiology. Additionally, augmented reality technologies are poised to reshape surgical planning by providing an immersive and interactive environment for surgeons to visualize and manipulate 3D reconstructions. Still, the future of preoperative planning in breast reconstruction holds immense promise. Most recently, artificial intelligence algorithms, utilising machine learning and deep learning techniques, have the potential to automate and enhance preoperative planning processes. This review provides a comprehensive assessment of the history of innovation in preoperative planning for breast reconstruction, while also outlining key future directions, and the impact of artificial intelligence in this field. Full article
(This article belongs to the Special Issue Current Advances in Breast Reconstruction)
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Other

7 pages, 5440 KiB  
Case Report
Breast Reconstruction after Breast Implant-Associated Anaplastic Large Cell Lymphoma Treatment: A Case Report and Literature Review
by Won-Seob Lee, Tae-Gon Kim, Jun-Ho Lee and Il-Kug Kim
J. Clin. Med. 2023, 12(5), 1885; https://doi.org/10.3390/jcm12051885 - 27 Feb 2023
Cited by 1 | Viewed by 1641
Abstract
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a T-cell non-Hodgkin’s lymphoma that occurs in patients with at least one prior textured breast implant. BIA-ALCL has a relatively good prognosis when treated promptly. However, data on the methods and timing of the reconstruction [...] Read more.
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a T-cell non-Hodgkin’s lymphoma that occurs in patients with at least one prior textured breast implant. BIA-ALCL has a relatively good prognosis when treated promptly. However, data on the methods and timing of the reconstruction process are lacking. Herein, we report the first case of BIA-ALCL in Republic of Korea in a patient who underwent breast reconstruction using implants and an acellular dermal matrix (ADM). A 47-year-old female patient was diagnosed with BIA-ALCL stage IIA (T4N0M0) and underwent bilateral breast augmentation using textured breast implants. She then underwent removal of both breast implants, total bilateral capsulectomy, adjuvant chemotherapy, and radiotherapy. There was no evidence of recurrence at 28 months postoperatively; therefore, the patient wished to undergo breast reconstruction surgery. A smooth surface implant was used to consider the patient’s desired breast volume and body mass index. The right breast was reconstructed with a smooth surface implant and an ADM in the prepectoral plane. Breast augmentation was performed on the left breast using a smooth surface implant. The patient was satisfied with the results and recovered fully with no complications. Full article
(This article belongs to the Special Issue Current Advances in Breast Reconstruction)
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