Reverse Expansion Technique for Total Autologous and Hybrid Breast Reconstruction: A Systematic Review and a...

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Oncology

Background:

• Reverse expansion (RE) is an advanced technique for transferring large volumes of autologous fat in breast reconstruction.
• This systematic review evaluates the efficacy and safety of RE, comparing hybrid and total autologous methods.

Purpose of the Study:

• To assess the efficacy and safety of reverse expansion (RE) in breast reconstruction.
• To compare hybrid and total autologous RE techniques regarding outcomes and complications.

Main Methods:

• Systematic search of Web of Science and PubMed (3117 records identified, 11 included).
• Analysis of parameters including fat grafting volume, number of sessions, radiotherapy status, and complications.
• Comparison between hybrid and total autologous groups, and between irradiated and non-irradiated patients.

Main Results:

• Total autologous RE involved significantly more fat volume per session (288 mL vs. 105 mL) and per breast (742 mL vs. 228 mL) than hybrid RE.
• Total autologous RE required more sessions (2.6 vs. 2) but had lower complication rates.
• Patients receiving radiotherapy needed significantly more RE sessions.

Conclusions:

• Total autologous RE, while requiring more volume and sessions, results in lower overall complication rates.
• Radiotherapy is a significant factor, increasing the number of RE sessions and fat volume required for breast reconstruction.