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Clinical Advances of Breast Surgery and 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: 30 November 2025 | Viewed by 1280

Special Issue Editors


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Guest Editor
Clinic of Plastic and Reconstructive Surgery, Ospedale Santa Maria della Misericordia, 33100 Udine, Italy
Interests: breast reconstructive surgery; microsurgery; post-bariatric surgery; vulvo-perineal reconsructive surgery
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Guest Editor
Plastic Surgery and Microsurgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56121 Pisa, Italy
Interests: microsurgery; breast reconstruction; head and neck; lymphatics; sarcoma; lower limb reconstruction; melanoma; autologous breast reconstruction
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are in the era of increasingly personalized surgery, and never as in the field of breast surgery is this concept fully founded.

As regards non-neoplastic breast surgery, each of us handles his or her own techniques of reductive mastoplasty, mastopexy, and additive mastoplasty, using them ad hoc according to the indications and the degree of confidence that one has in this rather than in that technique.

In the current multidisciplinary scenario in which the problem of breast cancer is addressed, the plastic surgeon plays a crucial role in finding the most appropriate reconstructive solution for each patient. In fact, he can give wide vent to his creativity combined with the most advanced knowledge and technologies to guarantee a custom-made reconstruction result that meets international standards, with which we are called to compare. Starting from locoregional perforating flaps for complete or partial autologous reconstruction, through pre-pectoral heterologous reconstruction with or without the use of ADM, up to the most complex microsurgical interventions, where a very high level of expertise is required.

In addition, thanks to the advancements in microbiological assessment and the increasingly efficient medical devices available, we are also able to tackle infectious complications in implant-based reconstruction from a more conservative perspective, something that was unthinkable until a few years ago.

In this broad scenario, you are all invited to express your ideas and share your experiences, thanks to which we will make this Special Issue unique.

Dr. Glenda Giorgia Caputo
Prof. Dr. Emanuele Cigna
Guest Editors

Manuscript Submission Information

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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
  • autologous breast reconstruction
  • implant-based breast reconstruction
  • DIEP
  • LICAP
  • breast implant infection

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Published Papers (1 paper)

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Research

13 pages, 2915 KB  
Article
Superficial vs. Deep Venous System in DIEP Flaps: Lessons from 25 Years of CTA-Guided Planning
by Ferruccio Paganini, Sara Matarazzo, Beatrice Corsini, Elvio De Fiori, Andrea Manconi, Luigi Valdatta, Valeria Navach and Cristina Garusi
J. Clin. Med. 2025, 14(17), 5972; https://doi.org/10.3390/jcm14175972 - 24 Aug 2025
Viewed by 240
Abstract
Background: Venous congestion is a major contributor to complications in DIEP flap breast reconstruction. Beyond superficial venous dominance, the presence or absence of anatomical connections between the superficial and deep venous systems may influence drainage physiology. This study investigates how preoperative CTA [...] Read more.
Background: Venous congestion is a major contributor to complications in DIEP flap breast reconstruction. Beyond superficial venous dominance, the presence or absence of anatomical connections between the superficial and deep venous systems may influence drainage physiology. This study investigates how preoperative CTA and targeted superdrainage impact outcomes over a 25-year period. Patients and Methods: A retrospective analysis was conducted on 208 DIEP flaps performed from 2000 to 2024 at a single center. From 2006, computed tomographic angiography (CTA) was routinely used to evaluate venous anatomy, focusing on the presence, trajectory, and connection of the superficial inferior epigastric vein (SIEV) with the deep system. Superdrainage was performed when superficial venous dominance was evident or drainage was judged insufficient intraoperatively. Primary outcomes included venous congestion, partial necrosis, and reoperations; secondary outcomes included hospital stay and safety of superdrainage. Results: Venous complications decreased significantly after CTA implementation (37.5% vs. 8.0%; p < 0.001). Superdrainage was performed in 40.9% of post-CTA cases, with 90% preoperatively planned based on CTA findings. No complications were associated with second venous anastomosis. Flap outcomes correlated not with perforator number or flap size but with venous drainage physiology. Mean hospital stay was shorter post-CTA (6 vs. 9 days; p < 0.001). Conclusions: Evaluating the anatomical connection between superficial and deep venous systems via CTA enhances venous planning and allows for safer, physiology-driven decisions. In the absence of such connections, intraoperative evaluation remains essential. Drainage physiology—rather than anatomical metrics alone—should guide surgical strategy in DIEP flap reconstruction. Full article
(This article belongs to the Special Issue Clinical Advances of Breast Surgery and Reconstruction)
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