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Breast Reconstruction: Current Challenges and Future Perspectives
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Breast Reconstruction: Current Challenges and Future Perspectives

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 (30 September 2024) | Viewed by 2121

Special Issue Editors

Dr. Ahmad Kaviani

E-Mail Website
Guest Editor
Department of Surgical Oncology, University of Montreal, PO Box 6128 Montreal, Canada
Interests: oncoplastic breast surgery; breast reconstruction; breast cancer
Dr. Alain Michel Danino

E-Mail Website
Co-Guest Editor
Department of Surgery, University of Montreal, Montreal, QC PO Box 6128, Canada
Interests: plastic surgery; breast implant; allotransplantation
Dr. Alfred D. Fitoussi

E-Mail Website
Co-Guest Editor
Curie Institute, 75005 Paris, France
Interests: plastic surgery; breast cancer; breast reconstruction

Special Issue Information

Dear Colleagues,

Since Professor Vincent Czerny's groundbreaking autologous breast reconstruction (BR) in 1895, the concept and techniques of this practice have continuously evolved. Despite the remarkable progress made in this field, there are notable concerns that warrant special attention, particularly with the increasing survival of patients following radiotherapy and, as a consequence, higher rates of recurrence and mastectomies. This poses a distinct challenge for implant-based breast reconstruction, especially in the context of emerging trends like pre-pectoral direct-to-implant BR. The routine use of ADMs as part of prosthesis-based reconstruction has its own disadvantages, including complications, high costs, and availability issues. On the other hand, well-established autologous free flap reconstructions face scrutiny related to the complexity of the procedures and associated complication rates, prompting an important question: are these techniques overly burdensome for breast reconstruction? In light of these challenges, the gradual emergence of fat grafting and stem cells represents a promising new field that warrants further development.

This Special Issue of the Journal of Clinical Medicine, entitled "Breast Reconstruction: Current Challenges and Future Perspectives", aims to address the current obstacles faced by the health system. Our goal is to identify novel methods capable of overcoming these new challenges, thereby representing a significant step forward in the field of breast reconstruction.

Dr. Ahmad Kaviani
Dr. Alain Michel Danino
Dr. Alfred D. Fitoussi
Guest Editors

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
  • oncoplastic surgery
  • fat grafting
  • breast implant
  • autologous flap

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Published Papers (2 papers)

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Review

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28 pages, 2208 KiB  
Review
Flap Monitoring Techniques: A Review
by Ignacy Rogoń, Agnieszka Rogoń, Mariusz Kaczmarek, Adam Bujnowski, Jerzy Wtorek, Filip Lachowski and Jerzy Jankau
J. Clin. Med. 2024, 13(18), 5467; https://doi.org/10.3390/jcm13185467 - 14 Sep 2024
Viewed by 600
Abstract
Postoperative tissue flap vitality monitoring enables early detection of clinical complications, allowing for intervention. Timely re-operation can prevent the need for extensive correction procedures, thus reducing healthcare costs and hospitalization time. Statistics show that monitoring can increase the success rate of flap survival [...] Read more.
Postoperative tissue flap vitality monitoring enables early detection of clinical complications, allowing for intervention. Timely re-operation can prevent the need for extensive correction procedures, thus reducing healthcare costs and hospitalization time. Statistics show that monitoring can increase the success rate of flap survival to 95% or higher. However, despite the significant progress in monitoring techniques, major and minor complications, leading to the loss of the flap, still occur. This clinical application review aims to provide a comprehensive overview of the recent advancements and findings in flap surgery reconstructions, transplants, and systems for their postoperative assessment. The literature from the years 1925 to 2024 has been reviewed to capture previous and current solutions for monitoring flap vitality. Clinically acclaimed methods and experimental techniques were classified and reviewed from a technical and clinical standpoint. Physical examination, metabolism change, ultrasound method, and electromagnetic (EM) radiation-based measurement methods were carefully evaluated from the perspective of their considered applications. Guidelines aiding engineers in the future design and development process of monitoring systems were proposed. This paper provides a comprehensive overview of the monitoring techniques used in postoperative flap vitality monitoring. It also gives an overview of each approach and potential ways for future development. Full article
(This article belongs to the Special Issue Breast Reconstruction: Current Challenges and Future Perspectives)
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Other

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15 pages, 3474 KiB  
Systematic Review
The Influence of Inset and Shaping of Abdominal-Based Free Flap Breast Reconstruction on Patient-Reported Aesthetic Outcome Scores—A Systematic Review
by Isabel Zucal, Laura De Pellegrin, Corrado Parodi, Yves Harder and Riccardo Schweizer
J. Clin. Med. 2024, 13(8), 2395; https://doi.org/10.3390/jcm13082395 - 19 Apr 2024
Viewed by 1215
Abstract
Background: Nowadays, multimodal cancer therapy results in very high survival rates of early-stage breast cancer and microsurgical flap-based breast reconstruction has become safe and reliable, with gradually increasing demand because of its durable and aesthetically pleasing results. This study aimed to explore the [...] Read more.
Background: Nowadays, multimodal cancer therapy results in very high survival rates of early-stage breast cancer and microsurgical flap-based breast reconstruction has become safe and reliable, with gradually increasing demand because of its durable and aesthetically pleasing results. This study aimed to explore the impact of different flap shaping and inset techniques on patient-reported outcome measures (PROMs) with regard to the aesthetic result in abdominal flap-based breast reconstruction. Methods: A systematic review was performed screening Pubmed, Cochrane Library and Web of Science for original articles reporting flap inset strategies, concomitantly providing PROMs on the aesthetic result. Results: Of 319 studies identified, six met the inclusion criteria. The studies described different flap rotation options according to the patient’s morphology, different inset planes, and avoidance of the monitoring skin paddle, and suggested that a higher flap-to-mastectomy mass ratio was associated with better aesthetic results. In two comparative studies, according to the PROMs (BREAST-Q, Likert scale) and independent observer judgement, both higher patient satisfaction and superior aesthetic results were observed with the newly described techniques. Conclusions: Emphasis on the aesthetic outcome in terms of breast shape and symmetry, providing an individualized approach of flap inset, considering the contralateral breast’s shape and volume, results in higher satisfaction scores. Full article
(This article belongs to the Special Issue Breast Reconstruction: Current Challenges and Future Perspectives)
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