ASPS clinical practice guideline summary on breast reconstruction with expanders and implants

Area of Science:

• Plastic Surgery
• Oncology
• Surgical Outcomes

Background:

• The American Society of Plastic Surgeons developed an evidence-based guideline for breast reconstruction using expanders and implants.
• The guideline addresses ten key clinical questions relevant to patient care and outcomes.

Purpose of the Study:

• To provide evidence-based recommendations for expander/implant breast reconstruction.
• To guide clinicians on patient education, risk factor assessment, and management of complications.
• To optimize oncologic outcomes and surgical results in breast reconstruction.

Main Methods:

• Systematic review of evidence on expander/implant breast reconstruction.
• Development of clinical questions covering various aspects of the procedure.
• Expert consensus and guideline formulation by a work group.

Main Results:

• Preoperative referral to a plastic surgeon is recommended for mastectomy patients.
• Limited evidence exists on optimal timing of reconstruction with radiation therapy, but irradiation increases complication risk.
• Appropriate preoperative antibiotic use is supported, with discontinuation within 24 hours unless drains are present.

Conclusions:

• Expander/implant breast reconstruction does not negatively impact oncologic outcomes.
• Guidelines aim to improve clinical outcomes and reduce complications in breast reconstruction.
• Further research may be needed to clarify optimal timing and acellular dermal matrix use.