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Clinical Advances of Breast Surgery and Reconstruction
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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: 25 May 2026 | Viewed by 3322

Special Issue Editors

Dr. Glenda Giorgia Caputo

E-Mail Website
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
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Emanuele Cigna

E-Mail Website
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

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 250 words) can be sent to the Editorial Office for assessment.

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

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Published Papers (3 papers)

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Research

15 pages, 631 KB  
Article
Postoperative Management with a Polyurethane Cup Containing an Oxygenated Oleic Matrix in Nipple-Sparing Mastectomy with Immediate Reconstruction: A Single-Center Retrospective Observational Study
by Giulia Deguidi, Lorenzo Bertoldi, Marina Caldana, Sara Mirandola, Valeria Tombolan, Giuseppe Biondo, Alessia Scirpoli and Francesca Pellini
J. Clin. Med. 2026, 15(8), 3092; https://doi.org/10.3390/jcm15083092 - 17 Apr 2026
Abstract
Background/Objectives: Nipple-sparing mastectomy with immediate reconstruction is a preferred option for selected patients undergoing prophylactic or therapeutic mastectomy. Optimizing postoperative wound care is essential to support healing, preserve the nipple–areola complex, and prevent delays in oncologic treatments. This retrospective observational study aimed [...] Read more.
Background/Objectives: Nipple-sparing mastectomy with immediate reconstruction is a preferred option for selected patients undergoing prophylactic or therapeutic mastectomy. Optimizing postoperative wound care is essential to support healing, preserve the nipple–areola complex, and prevent delays in oncologic treatments. This retrospective observational study aimed to evaluate the clinical outcomes associated with the use of the NovoX® Cup medical device in post-NSM surgical wound management, assessing clinical–surgical outcomes and quality of life (QoL). Methods: We conducted a retrospective observational study on 54 patients who underwent NSM with immediate reconstruction at AOUI Verona between January 2025 and January 2026; Novox® Cup was applied intraoperatively and changed every 48 h according to protocol. Surgeon-reported outcomes were assessed by the skin flap viability scale and the complications by Clavien–Dindo classification. Patient-reported outcomes were assessed via the Wound-QoL17 questionnaire at 7, 30, and 90 days. Clinical outcomes were supported by photographic documentation. Results: Mean age was 51.5 years; BMI averaged 23.9 kg/m2. Local complications occurred in 30.4% of cases (infections 12%, dehiscence 10%, seromas 4%). Mean healing time was 15 days, with 87.4% of patients having drains removed by day 14. One patient required surgical revision, and one (1.8%) experienced delayed adjuvant therapy. Wound-QoL17 responses showed minimal discomfort and high satisfaction. Clinical evaluation revealed favorable wound appearance and preserved NAC perfusion within 48 h. Conclusions: Novox® Cup appears effective in supporting wound healing and NAC preservation after NSM, with high patient satisfaction and minimal treatment delays. Its integration into postoperative care may enhance outcomes and maintain oncologic timelines. Full article
(This article belongs to the Special Issue Clinical Advances of Breast Surgery and Reconstruction)
12 pages, 3262 KB  
Article
Impact of Contralateral Implant Placement in Unilateral Implant-Based Postmastectomy Breast Reconstruction: A Single Center Retrospective Cohort Study
by Salvatore D’Arpa, Giuseppe Antonio D’Amico, Giulio Jad Jaber, Michele Rosario Colonna and Massimo David
J. Clin. Med. 2026, 15(1), 375; https://doi.org/10.3390/jcm15010375 - 4 Jan 2026
Viewed by 518
Abstract
Background/Objectives: Investigating how placement of a contralateral breast implant in the context of unilateral implant-based breast reconstruction influences aesthetic and patient-reported outcomes. Methods: A retrospective analysis was performed on a single-center prospectively maintained database (January 2021–March 2025) including patients who underwent [...] Read more.
Background/Objectives: Investigating how placement of a contralateral breast implant in the context of unilateral implant-based breast reconstruction influences aesthetic and patient-reported outcomes. Methods: A retrospective analysis was performed on a single-center prospectively maintained database (January 2021–March 2025) including patients who underwent unilateral implant-based breast reconstruction in association with a contralateral implant placement or not. Exclusion criteria were bilateral implant-based reconstruction or autologous reconstruction, follow-up of less than 6 months and missing data. Demographics and complications were analyzed. Aesthetic outcomes were evaluated by independent blinded surgeons using the Kroll Scale, patient satisfaction was investigated with the BREAST-Q Reconstruction Module v2.0. Statistical analysis used the Student’s t-test, Multivariate regression analysis and Mann–Whitney U test with significance set at p < 0.05. Results: The study group included 21 patients (40.4%) who received a contralateral implant, while the control group included 31 patients (59.6%) who did not receive a contralateral implant. Patients who received contralateral implants showed a significant improvement in cosmetic outcomes evaluated with the Kroll Scale and a raw increment, without statistical significance, in BREAST-Q scores in all subsections investigated (Psychosocial well-being, Sexual well-being and Satisfaction with breasts). Conclusions: Placing a contralateral breast implant in the context of unilateral implant-based breast reconstruction significantly improves aesthetic outcomes and correlates with higher patient satisfaction scores for the reconstructed breast, compared to placing no contralateral implant, without increasing the overall complication rate. Full article
(This article belongs to the Special Issue Clinical Advances of Breast Surgery and Reconstruction)
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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 1310
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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