A multicenter study on microsurgical procedures to treat congenital and acquired breast abnormalities

Breast abnormalities present complex reconstructive challenges requiring a tailored surgical approach combining both esthetic and reconstructive breast surgery. The purpose of this study was to evaluate the reliability of microsurgical procedures for the correction of breast abnormalities.

We conducted a retrospective multicenter study on female patients who underwent microsurgical procedures to correct congenital or acquired breast abnormalities in four plastic surgery units (January 2010-December 2024). The indications, microsurgical technique, and refinement surgeries were analyzed.

In 40 patients (median age, 42 years; median BMI, 23.9 kg/m²) 52 microsurgical procedures were performed. Congenital abnormalities included Poland syndrome (N = 9), aplasia/hypoplasia (N = 5), and tuberous breast (N = 4). Acquired abnormalities resulted from non-oncologic breast surgery (N = 7), chronic abscesses formation (N = 6), massive weight loss (N = 1), burns (N = 4), and failed cosmetic surgery (N = 4). Thirty-four patients had previous surgical interventions. Abdominal-based flaps (N = 26) were used more often than alternative flaps (TMG, N = 14). The flap survival rate was 96%. In 23 patients, on an average 2 refinement procedures were performed to optimize the result.

This multicenter study highlights the versatility and reliability of microsurgical procedures to correct breast abnormalities. Given the esthetic adaptability and evident advantages of microsurgical breast reconstruction in patients with breast cancer, this surgical approach should be considered as a valuable alternative in patients without cancer, particularly those with implant-associated complications, tissue excess, or younger individuals seeking a natural solution.