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Managing Complications of Reconstructive and Aesthetic Breast Surgery
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Managing Complications of Reconstructive and Aesthetic Breast Surgery

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 (25 September 2024) | Viewed by 3744

Special Issue Editor

Prof. Dr. Yoav Barnea

E-Mail Website
Guest Editor
Department of Plastic and Reconstructive Surgery, Tel-Aviv Sourasky Medical Center, Affiliated with the Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Interests: aesthetic breast surgery; alloplastic breast reconstruction; autologous breast reconstruction; breast reduction; oncoplastic surgery; multidisciplinary breast team

Special Issue Information

Dear Colleagues,

It is our great pleasure to present this Special Issue on managing complications of reconstructive and aesthetic breast surgery. This topic is significant in breast surgery as timely diagnosis and treatment of breast surgery complications can dramatically change the course of recovery from surgery and have an imperative effect on the operative outcome. As our technique in breast surgery evolves, with the emergence of new devices and technologies, we have the opportunity to reduce the rate of complications and improve the management and outcome. We welcome authors to submit papers on managing complications in breast surgery, both aesthetic and reconstructive.

Prof. Dr. Yoav Barnea
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

  • complications
  • breast surgery 
  • aesthetic breast 
  • reconstructive breast 
  • complication management

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Further information on MDPI's Special Issue polices can be found here.

Published Papers (3 papers)

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Research

10 pages, 1967 KiB  
Article
Avoiding Chest Wall Morbidity in Outpatient Microvascular Free-Flap Breast Reconstruction
by Carlos A. Martinez and Sean G. Boutros
J. Clin. Med. 2025, 14(2), 602; https://doi.org/10.3390/jcm14020602 - 18 Jan 2025
Viewed by 375
Abstract
Background. Removal of the rib and adjacent cartilage is a common step for exposure of the recipient chest vessels in free-flap breast reconstructions. However, this adds both short- and long-term morbidity to the procedure. We describe our experience in avoiding rib removal in [...] Read more.
Background. Removal of the rib and adjacent cartilage is a common step for exposure of the recipient chest vessels in free-flap breast reconstructions. However, this adds both short- and long-term morbidity to the procedure. We describe our experience in avoiding rib removal in microvascular breast reconstruction. Patients and Methods. We retrospectively reviewed recipient vessel preparation in free-flap breast reconstructions performed by a single surgeon (SGB). Results. A total of 556 consecutive patients, totaling 1106 flaps over 5 years, were assessed. Recipient vessels included IMA in 1068 flaps and internal mammary perforator in 38 DIEP flaps. Nine patients underwent bilateral DIEP flap breast reconstruction with a cross-chest anastomosis, where the IMA was the recipient. Also, the IMA was used in 171 patients who underwent breast reconstruction with stacked flaps. No instances of complete rib resection were reported. However, in two cases of delayed DIEP flap reconstruction without a history of radiation, resection of 20% of the rib was required for safe vessel preparation. No intraoperative complications were observed, and three flaps from different patients were lost (one PAP and two DIEPs). Conclusions. Microsurgery in free-flap breast reconstructions has greatly evolved in the past two decades. Exposure of the IMA recipient vessels typically involves the removal of a portion of the intercostal cartilage and the rib, allowing comfortable and safe management of the vasculature during dissection and anastomosis. Nonetheless, excessive removal often leads to short-term increased pain and long-term cosmetic and functional complications, such as a noticeable depression of the chest wall especially noted in thin patients with small flaps. Our approach can be safely employed to preserve the anatomy and decrease pain, allowing for outpatient performance of these procedures. Full article
(This article belongs to the Special Issue Managing Complications of Reconstructive and Aesthetic Breast Surgery)
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10 pages, 3562 KiB  
Article
Comparative Efficacy of Classic Versus Horizontal Incision Techniques in Skin-Reducing Mastectomy: A Single Center Retrospective Analysis
by Andrea Vittorio Emanuele Lisa, Alessandro Mela, Sergio Miranda, Mario Alessandri Bonetti, Manuela Bottoni, Mattia Intra, Eleonora Pagan, Vincenzo Bagnardi and Mario Rietjens
J. Clin. Med. 2024, 13(20), 6276; https://doi.org/10.3390/jcm13206276 - 21 Oct 2024
Viewed by 693
Abstract
Background: The reconstruction of large breasts carries a heightened risk profile. While skin-reducing mastectomy (SRM) techniques facilitate the correction of breast ptosis, they are frequently associated with a high incidence of vascular complications. This study compares two SRM techniques—the horizontal incision and [...] Read more.
Background: The reconstruction of large breasts carries a heightened risk profile. While skin-reducing mastectomy (SRM) techniques facilitate the correction of breast ptosis, they are frequently associated with a high incidence of vascular complications. This study compares two SRM techniques—the horizontal incision and the classic inverted T incision—by examining their clinical and surgical outcomes. Methods: We retrospectively analyzed data from 24 patients (30 breasts) who underwent SRM with immediate prosthetic reconstruction between 2019 and 2023 at the European Institute of Oncology in Milan, Italy. Our comparison focused on breast aesthetic outcome, reconstruction quality, complication rates (early and late), and patient satisfaction, utilizing the BREAST-Q questionnaire to gauge the latter. Results: Among the 24 patients included in the study, 16 (20 breasts) were treated with the inverted T technique, and 8 (10 breasts) with the horizontal incision approach. A higher overall complication rate was observed with the inverted T technique compared to the horizontal method, with early complications outnumbering late ones. The most common issues were recurrent seroma and skin necrosis leading to implant exposure. Notably, there were no cases of implant infection. Although the horizontal incision technique achieved slightly higher patient satisfaction scores, the difference was not statistically significant. Discussion: The inverted T and horizontal incision techniques each have unique benefits and drawbacks. Our findings indicate enhanced patient satisfaction and reduced complication rates with the horizontal incision technique. The selection of the technique should be customized based on the patient’s individual risk factors, tissue quality, and preferences. Full article
(This article belongs to the Special Issue Managing Complications of Reconstructive and Aesthetic Breast Surgery)
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11 pages, 2313 KiB  
Article
Our Experience in Diagnosing and Treating Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)
by Gon Shoham, Oriana Haran, Roei Singolda, Ehab Madah, Ada Magen, Orit Golan, Tehillah Menes, Ehud Arad and Yoav Barnea
J. Clin. Med. 2024, 13(2), 366; https://doi.org/10.3390/jcm13020366 - 9 Jan 2024
Cited by 3 | Viewed by 2241
Abstract
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon T-cell lymphoma detected in association with textured implants. It presents as a fluid accumulation around the implant, usually years after the implantation. We present our experience in diagnosing and treating four patients with [...] Read more.
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon T-cell lymphoma detected in association with textured implants. It presents as a fluid accumulation around the implant, usually years after the implantation. We present our experience in diagnosing and treating four patients with BIA-ALCL, each widely differing from the other. Data on patients’ surgical history, relevant medical information, and findings on pathological slides were retrieved from their medical charts and retrospectively reviewed. Each of the four patients was diagnosed with BIA-ALCL, one after breast augmentation, one after breast reconstruction with an implant, one after breast reconstruction with a latissimus dorsi flap and implant, and the fourth after the removal of breast implants. The cases were presented to a multidisciplinary team and subsequently underwent surgery. All four are currently free of tumors, as established by a negative follow-up via positron emission tomography-computed tomography. Although the incidence of BIA-ALCL is rare, these cases emphasize the need to rule out the diagnosis of BIA-ALCL in patients with textured implants or a history of implanted textured devices who present with symptoms such as late seroma or peri-implant mass. This pathology is typically indolent and slow-growing and heightened awareness for an early diagnosis could lead to quicker intervention and enhanced patient management. Full article
(This article belongs to the Special Issue Managing Complications of Reconstructive and Aesthetic Breast Surgery)
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