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Evolution and practice pattern in microsurgical breast reconstruction: a European multicenter study

Background - This study investigated the evolution and practice pattern in microsurgical breast reconstruction. - Methods - A retrospective multicenter study was conducted including all patients who underwent microsurgical breast reconstruction in 6 European medical centers (January 2010 to December...

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Main Authors: Siegwart, Laura (Author) , Grünherz, Lisanne (Author) , Weitgasser, Laurenz (Author) , Mahrhofer, Maximilian (Author) , Abdallah, Nour Abu (Author) , Fertsch, Sonia (Author) , Wolter, Andreas (Author) , Schneider, Laura (Author) , Moncher, Johanna (Author) , Erdmann, Stella (Author) , Bigdeli, Amir Khosrow (Author) , Lindenblatt, Nicole (Author) , Schoeller, Thomas (Author) , Eisenhardt, Steffen Ulrich (Author) , Wechselberger, Gottfried (Author) , Andree, Christoph (Author) , Kneser, Ulrich (Author)
Format: Article (Journal)
Language:English
Published: July 2025
In: Journal of plastic, reconstructive & aesthetic surgery
Year: 2025, Volume: 106, Pages: 254-264
ISSN:1878-0539
DOI:10.1016/j.bjps.2025.05.011
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.bjps.2025.05.011
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S1748681525003158
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Author Notes:Laura Cosima Siegwart, Lisanne Grünherz, Laurenz Weitgasser, Maximilian Mahrhofer, Nour Abu Abdallah, Sonia Fertsch, Andreas Wolter, Laura Schneider, Johanna Moncher, Stella Erdmann, Amir Khosrow Bigdeli, Nicole Lindenblatt, Thomas Schoeller, Steffen Ulrich Eisenhardt, Gottfried Wechselberger, Christoph Andree, Ulrich Kneser
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Summary:Background - This study investigated the evolution and practice pattern in microsurgical breast reconstruction. - Methods - A retrospective multicenter study was conducted including all patients who underwent microsurgical breast reconstruction in 6 European medical centers (January 2010 to December 2019). Patients were grouped according to the flap in the abdominal or alternative group. The patient and outcome data were merged for comparative analysis. Linear regression analysis was used to objectify the evolution in microsurgical breast reconstruction. A multiple mixed effects logistic regression model was applied to identify the predictors for the flap choice. - Results - A total of 4025 microsurgical breast reconstructions were performed in 3344 patients. Among them, 2891 (86%) patients with 3440 flaps were included in the abdominal group and 453 (14%) patients with 585 flaps were included in the alternative group. There was a significant increase (3.7% per year, p = 0.019) in microsurgical breast reconstruction and alternative flaps usage (12.6% per year, p < 0.001). The deep inferior epigastric perforator, transverse musculocutaneous gracilis, and muscle-sparing - transverse rectus abdominis muscle flap were used in >90% cases. The groups differed significantly in characteristics, perioperative, and postoperative parameters. Age, body mass index, radiotherapy, breast reconstruction laterality, the type of mastectomy, and previous implant failure were significant predictors for the flap choice. - Conclusions - This multicenter study outlined a significant increase in microsurgical breast reconstruction and continuous evolution to alternative flaps since 2010. It objectivized the relation of surgical and adjuvant breast cancer therapy on future options in microsurgical breast reconstructions and showed that customized concepts allow each patient in her unique situation to choose natural breast reconstruction.
Item Description:Online verfügbar: 14. Mai 2025, Artikelversion: 30. Mai 2025
Gesehen am 17.09.2025
Physical Description:Online Resource
ISSN:1878-0539
DOI:10.1016/j.bjps.2025.05.011

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