Breast Reconstruction: The Current Environment and Future Directions

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Guest Editor
Department of Plastic Surgery, University of Virginia Health System, Charlottesville, VA 22908, USA
Interests: breast reconstruction; plastic surgery; microsurgery; trunk and extremity reconstruction; cancer resection; head and neck reconstruction

Special Issue Information

Dear Colleagues,

The field of breast reconstruction is constantly evolving, aiming to enhance patient experience and achieve optimal results. In today's healthcare landscape, informed patients are seeking the best clinical outcomes, leading to a growing demand for breast reconstruction procedures. Regulatory scrutiny of implantable devices used in these procedures places a significant responsibility on plastic surgeons to gather and assess data rigorously, ensuring high-quality care and continued access to advanced resources. Plastic surgeons are dedicated to improving patient access to breast reconstruction by streamlining processes, managing costs efficiently and prioritizing patient satisfaction.

This issue focuses on the changing landscape of plastic and reconstructive surgery.

Dr. Chris A. Campbell
Guest Editor

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Keywords

  • breast reconstruction
  • plastic surgery
  • microsurgery
  • trunk and extremity reconstruction
  • cancer resection
  • head and neck reconstruction

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Published Papers (2 papers)

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Research

13 pages, 3307 KiB  
Article
Preclinical Volume Retention of Fat Grafts Processed with REVOLVE™ Technology or Decantation Methods in Irradiated and Nonirradiated Wounds
by Christopher A. Campbell, Graham M. Grogan, Samantha St. Jean, Nimesh Kabaria, Maryellen Gardocki-Sandor and Patrick S. Cottler
J. Clin. Med. 2025, 14(9), 3100; https://doi.org/10.3390/jcm14093100 - 30 Apr 2025
Viewed by 131
Abstract
Background: The processing of harvested fat for transplantation is critical to fat graft performance. In breast reconstruction, larger volumes of fat are being grafted and, in some clinical cases, are being implanted within radiated tissue. This preclinical animal study evaluated the effects of [...] Read more.
Background: The processing of harvested fat for transplantation is critical to fat graft performance. In breast reconstruction, larger volumes of fat are being grafted and, in some clinical cases, are being implanted within radiated tissue. This preclinical animal study evaluated the effects of radiation on retention volume and fat graft quality after processing by decantation or REVOLVE™ technology (Allergan Aesthetics, an AbbVie Company), a filtration-based device that can process lipoaspirates and remove unwanted contaminants prior to grafting. Methods: Lipoaspirate was collected from human donors (n = 6), processed using either REVOLVE™ technology or decantation, and implanted (0.5 cc) into 60 athymic mice for 4 weeks with or without a single 35-Gy radiation dose 12 weeks prior. Volume composition, MRI, and weight-based volumetric assessment of grafted fat were performed and compared between radiated and non-radiated mice. Results: Volume composition analysis demonstrated significantly higher fat content and lower aqueous fluid with REVOLVE™ technology than with decantation, with minimal cellular debris and free oil. MRI-based and weight-based volume analysis demonstrated a significantly higher percent retention with REVOLVE™ technology than decantation in nonirradiated and irradiated sites, respectively. Pathology scoring showed a significant decrease in fibrosis within grafts processed with REVOLVE™ technology in nonirradiated sites. Conclusions: Results suggest that fat processed using REVOLVE™ technology provides better early volume retention and quality of fat grafts compared to decantation, both in healthy and radiation-treated surgical sites. Full article
(This article belongs to the Special Issue Breast Reconstruction: The Current Environment and Future Directions)
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11 pages, 14092 KiB  
Article
Prevalence of Breast Cancer-Related Lymphedema in Israeli Women Following Axillary Procedures
by Daniel Josef Kedar, Elad Zvi, Oriana Haran, Lior Sherker, Michael Sernitski, Nadav Oppenheim, Eran Nizri, Marian Khatib and Yoav Barnea
J. Clin. Med. 2025, 14(3), 688; https://doi.org/10.3390/jcm14030688 - 22 Jan 2025
Viewed by 749
Abstract
Background/Objectives: Breast cancer-related lymphedema (BCRL) is a chronic complication of breast cancer treatment, leading to physical and psychological morbidity. While widely studied globally, the prevalence and risk factors for BCRL in Israeli patients remain unexplored. This study’s objectives were to determine the prevalence [...] Read more.
Background/Objectives: Breast cancer-related lymphedema (BCRL) is a chronic complication of breast cancer treatment, leading to physical and psychological morbidity. While widely studied globally, the prevalence and risk factors for BCRL in Israeli patients remain unexplored. This study’s objectives were to determine the prevalence of BCRL in Israeli women treated for breast cancer, validate the Hebrew-translated Norman Questionnaire (NQ) for BCRL screening, and identify risk factors associated with the condition. Methods: A single-center study was conducted at Tel Aviv Sourasky Medical Center, including 181 patients who underwent unilateral axillary lymph node interventions between 2015 and 2018. Participants completed the Hebrew-translated NQ, which was validated through clinical evaluation and circumference-based volume measurements in a subset of 20 patients. Prevalence rates and risk factors were analyzed using multivariate modeling. Results: The prevalence of BCRL was 20%, with rates varying by procedure: 8.9% for sentinel lymph node biopsy, 19.6% for lymph node sampling, and 37.5% for axillary lymph node dissection (ALND). Of the 35 patients with BCRL, only 14% had been previously diagnosed. Risk factors included ALND (OR = 97.31), a higher lymph node excision count (OR = 0.81), and referral to physiotherapy (OR = 133.50). The Hebrew NQ demonstrated strong validity (rs = 0.852; p < 0.001). Conclusions: This is the first study to estimate BCRL prevalence in Israeli women, highlighting underdiagnosis and the need for improved early detection. The Hebrew NQ is a reliable screening tool, enabling timely referral and intervention. Early diagnosis is crucial for optimizing treatment outcomes and improving the quality of life of BCRL patients. Full article
(This article belongs to the Special Issue Breast Reconstruction: The Current Environment and Future Directions)
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