Single-stage buried autologous breast reconstruction (BABR)

Area of Science:

• Plastic Surgery
• Oncology
• Reconstructive Surgery

Background:

• High oncological, aesthetic, and practical standards in breast reconstruction.
• Autologous breast reconstruction is the gold standard, enabling single-stage procedures.
• Previous studies report high revision rates for certain autologous techniques.

Purpose of the Study:

• To prospectively compare buried versus non-buried free flaps for breast reconstruction.
• To evaluate oncological safety, aesthetic results, and complication rates.
• To assess the need for revision surgeries in both techniques.

Main Methods:

• Prospective comparison of buried and non-buried free flaps in autologous breast reconstruction.
• Inclusion of all free autologous tissue transfers over 8 years by a single surgeon.
• Recording and comparison of demographic, oncologic, reconstructive details, complications, and revisions.

Main Results:

• 182 free flaps (69 buried, 113 with paddles) were performed on 156 patients.
• No significant demographic or complication differences between buried and paddle groups.
• 51% of buried flaps required no further surgery versus 29% of paddle flaps.

Conclusions:

• Buried autologous breast reconstruction is a safe and aesthetic single-stage option.
• This technique is particularly suitable with nipple-sparing mastectomy or reduction mammaplasty.
• Future research should include patient-reported outcomes and cost analysis.