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Advances in Breast Reconstruction: New Technologies Improving Clinical Outcomes
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Advances in Breast Reconstruction: New Technologies Improving Clinical Outcomes

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: 20 March 2026 | Viewed by 2700

Special Issue Editor

Prof. Dr. Luigi Antonio Valdatta

E-Mail Website
Guest Editor
Division of Plastic and Reconstructive Surgery, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
Interests: plastic and reconstructive surgery; microsurgery; breast surgery; wound healing; cosmetic surgery; hand surgery

Special Issue Information

Dear Colleagues,

Breast reconstruction is a critical component of post-mastectomy care and congenital breast malformation correction. Recent advancements in surgical techniques, biomaterials, fat grafting, and artificial intelligence (AI) have significantly enhanced reconstructive outcomes, improving both functional and esthetic results. This Special Issue will highlight the latest clinical applications of emerging technologies in breast reconstruction, providing a platform for research that directly impacts patient care.

Acellular dermal matrices (ADMs) have improved implant-based reconstruction by enhancing tissue integration and reducing complications. Next-generation prostheses and implant designs offer greater biocompatibility and durability, leading to better long-term outcomes. The integration of AI into surgical planning and intraoperative decision-making is revolutionizing precision in reconstructive procedures, reducing complications, and allowing personalized treatments. Additionally, innovations in corrective surgery for congenital and acquired breast deformities, including Poland syndrome and tuberous breast, are providing new surgical strategies to optimize patient-centered care.

Furthermore, lipofilling has gained increased importance in both primary and secondary breast reconstruction. Advances in fat grafting techniques, stem cell-enriched fat transfer, and the combination of lipofilling with other reconstructive approaches have expanded its indications, allowing for enhanced volume restoration, improved contouring, and better soft tissue quality. Currently, researchers are investigating the role of lipofilling in radiotherapy-damaged tissues, its regenerative potential, and the long-term effects on oncological safety.

For this Special Issue, we welcome original research and systematic reviews focusing on clinically relevant innovations in breast reconstruction, including lipofilling advancements, biomaterial innovations, AI-assisted techniques, and novel corrective procedures. We encourage submissions that explore the impact of new surgical approaches on patient outcomes, complication rates, and long-term safety. By gathering the latest evidence-based findings, we aim to advance the field of reconstructive surgery and improve clinical practice in breast reconstruction.

Dr. Luigi Antonio Valdatta
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
  • acellular dermal matrix (ADM)
  • artificial intelligence in surgery
  • advanced prostheses
  • breast malformation correction
  • 3D printing in reconstruction
  • robotic-assisted breast surgery
  • regenerative surgery

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Published Papers (3 papers)

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Research

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12 pages, 243 KB  
Article
Long-Term Outcome in Implant Breast Reconstruction and Radiotherapy: The Role of Fat Grafting
by Alessia De Col, Francesco Buttarelli, Melissa Akuma, Ferruccio Paganini and Anna Scevola
J. Clin. Med. 2025, 14(21), 7569; https://doi.org/10.3390/jcm14217569 - 25 Oct 2025
Viewed by 308
Abstract
Background: Capsular contracture remains one of the most challenging complications of implant-based breast reconstruction, particularly in patients undergoing postmastectomy radiotherapy (PMRT). Autologous fat grafting has been proposed as a regenerative strategy to mitigate radiation-induced damage, but long-term data are limited. Methods: We retrospectively [...] Read more.
Background: Capsular contracture remains one of the most challenging complications of implant-based breast reconstruction, particularly in patients undergoing postmastectomy radiotherapy (PMRT). Autologous fat grafting has been proposed as a regenerative strategy to mitigate radiation-induced damage, but long-term data are limited. Methods: We retrospectively reviewed women who underwent two-stage implant-based breast reconstruction followed by PMRT (50 Gy in 25 fractions) between 2010 and 2021 at Ospedale Sant’Anna, Como. Eligible patients subsequently received at least one session of autologous fat grafting after radiotherapy. Primary outcome was the incidence and severity of capsular contracture; secondary outcomes included the need for salvage autologous reconstruction, oncologic safety, and patient-reported satisfaction. Results: Thirty-two patients met inclusion criteria. The mean age was 56.1 years, and mean BMI was 23.8 kg/m2. All underwent submuscular two-stage reconstruction with anatomically shaped implants (mean volume 336 cc). Patients received an average of 1.7 fat grafting sessions (mean cumulative volume 180 cc). At a mean follow-up of 7.7 years, capsular contracture occurred in 6 patients (18.8%): 4 with Baker grade III and 2 with Baker grade II. No cases of severe (grade IV) contracture were observed. Importantly, no patient required salvage autologous reconstruction, and no local recurrences were recorded. Minor donor-site complications (transient edema or ecchymosis) occurred in 18.7% of patients. Subjective satisfaction was uniformly high, with reported improvements in breast softness and contour. Conclusions: Fat grafting appears to be a safe and effective adjunct in maintaining implant-based breast reconstruction after radiotherapy. In this long-term series, lipofilling was associated with a lower incidence of capsular contracture compared with historical rates, absence of severe contracture, and no oncologic events. For selected patients who are not candidates for autologous reconstruction, fat grafting may represent a valuable strategy to preserve implant viability, improve tissue quality, and reduce the need for salvage procedures. Full article
(This article belongs to the Special Issue Advances in Breast Reconstruction: New Technologies Improving Clinical Outcomes)
16 pages, 2528 KB  
Article
Long-Term Shape and Volume Retention of Acellular Dermal Matrix in Oncoplastic Breast-Conserving Surgery: A 2-Year Retrospective Study
by Hyung-suk Yi, Jeong-jin Park, Jin-hyung Park, Hong-Il Kim, Jong-Hyouk Yun, Sung-ui Jung, Jin-hyuk Choi, Ku-sang Kim and Yoon-soo Kim
J. Clin. Med. 2025, 14(9), 3002; https://doi.org/10.3390/jcm14093002 - 26 Apr 2025
Viewed by 1413
Abstract
Background/Objectives: To quantitatively assess the long-term volume stability of acellular dermal matrix (ADM) in oncoplastic breast-conserving surgery (OBCS) and analyze surgical and aesthetic outcomes. Methods: This retrospective study examined 172 breast cancer patients who underwent OBCS with immediate ADM-based volume replacement [...] Read more.
Background/Objectives: To quantitatively assess the long-term volume stability of acellular dermal matrix (ADM) in oncoplastic breast-conserving surgery (OBCS) and analyze surgical and aesthetic outcomes. Methods: This retrospective study examined 172 breast cancer patients who underwent OBCS with immediate ADM-based volume replacement (2020–2022). Patients received either diced ADM with sheet ADM (n = 102) or diced ADM with paste ADM (n = 70). The ADM volume was evaluated using MRI at 6, 12, and 24 months postoperatively. Results: Long-term volume stability was achieved in both groups with minimal volume reduction (4.3–4.5%) at 24 months (p < 0.001). Early surgical complications included hematoma (4.1%), seroma (2.3%), and wound issues (1.2%), with no infections or ADM non-incorporation. Contour irregularities occurred in 16.3% of cases. Radiotherapy (87% of patients) did not significantly impact ADM volume retention. Conclusions: ADM provides predictable, durable volume replacement in OBCS, with excellent volume stability even with radiotherapy. This quantitative assessment of ADM volume retention over two years supports ADM as a reliable option for breast-conserving surgery, potentially expanding treatment options for patients with unfavorable tumor-to-breast volume ratios. Full article
(This article belongs to the Special Issue Advances in Breast Reconstruction: New Technologies Improving Clinical Outcomes)
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Review

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15 pages, 349 KB  
Review
Optimizing Aesthetic Results in Implant-Based Breast Reconstruction: Patient Factors, Surgical Techniques, and Adjunctive Strategies
by Elisa Bertulla and Edoardo Raposio
J. Clin. Med. 2025, 14(19), 7106; https://doi.org/10.3390/jcm14197106 - 9 Oct 2025
Viewed by 665
Abstract
Background: Breast reconstruction following mastectomy plays a crucial role in breast cancer management, restoring physical form and significantly impacting psychological well-being and quality of life. Implant-based breast reconstruction (IBBR) is the most performed technique worldwide due to its relative simplicity, shorter operative [...] Read more.
Background: Breast reconstruction following mastectomy plays a crucial role in breast cancer management, restoring physical form and significantly impacting psychological well-being and quality of life. Implant-based breast reconstruction (IBBR) is the most performed technique worldwide due to its relative simplicity, shorter operative times, and avoidance of donor site morbidity. Achieving satisfactory aesthetic outcomes, however, remains challenging, as multiple factors—including patient characteristics, surgical technique, implant selection, timing of reconstruction, and adjuvant therapies—can influence the final appearance. Methods: Literature research was performed via PubMed, Scopus and Cochrane Library Database, focusing on studies examining aesthetic outcomes in implant-based breast reconstruction published between 2015 and 2025. Data on type of study, sample size, aesthetic evaluation methods, and duration of follow-up were collected and summarized. Results: Among 747 articles identified, only 25 articles fulfilled inclusion criteria, including mostly retrospective studies, but also prospective studies, randomized clinical trials, and reviews. Factors such as BMI, inframammary fold management, and implant selection were consistently reported to influence aesthetic outcomes. Surgical techniques including ADM use, axillary advancement sutures, hybrid reconstruction with fat grafting, and prepectoral implant placement were associated with improved patient satisfaction. Patient satisfaction often differs from surgeon-assessed outcomes, emphasizing the importance of subjective evaluation. Conclusions: Despite the heterogeneity and retrospective nature of many studies, evidence indicates that optimizing aesthetic outcomes in IBBR relies on careful patient selection, tailored surgical planning, and meticulous use of evidence-based techniques, including implant selection, flap-based support, and adjunctive strategies. Patient-reported outcomes are essential for evaluating success, and future research should focus on standardized outcome measures and prospective studies to further refine reconstructive approaches and maximize both cosmetic satisfaction and quality of life. Full article
(This article belongs to the Special Issue Advances in Breast Reconstruction: New Technologies Improving Clinical Outcomes)
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