Radiation and free flaps: what is the optimal timing?

Area of Science:

• Oncology
• Plastic Surgery
• Radiotherapy

Background:

• Traditionally, autologous flaps were avoided during radiotherapy due to complication concerns.
• Delayed reconstruction presents its own risks and aesthetic limitations.

Purpose of the Study:

• To review and evaluate the literature on autologous breast reconstruction timing relative to post-mastectomy radiotherapy.
• To compare immediate versus delayed reconstruction outcomes.

Main Methods:

• Systematic literature review and critical evaluation of existing studies.
• Analysis of outcomes including surgical complications, aesthetic results, flap contracture, and fat necrosis.

Main Results:

• Modern radiation techniques may yield similar long-term outcomes for immediate and delayed reconstruction.
• Immediate reconstruction offers psychosocial benefits and preserves native breast tissue.

Conclusions:

• Immediate flap reconstruction is a viable and safe option for patients undergoing post-mastectomy radiotherapy.
• Patient-centric decisions based on multidisciplinary consensus are crucial.