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Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Hyperbaric Oxygen Therapy for Ischemic Complications After Immediate Breast Reconstruction: A Systematic Review and
José-Emiliano González-Flores1, Aarón González-Espinosa2, Alfonso Sandoval-Polito3
1School of Medicine and Health Sciences, Instituto Tecnológico y de Estudios Superiores de Monterrey (ITESM) Mexico City Campus, Mexico City, Mexico. emi_0947@hotmail.com.
Aesthetic Plastic Surgery
|June 10, 2026
Summary
Hyperbaric oxygen therapy (HBOT) may improve outcomes for breast reconstruction by salvaging flaps and pockets. While generally safe, more research is needed to confirm its effectiveness in the early postoperative phase.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Hyperbaric Medicine
Background:
- Hyperbaric oxygen therapy (HBOT) is explored as an adjunct to improve perfusion and salvage rates in breast reconstructions.
- The role of HBOT in the early postoperative period of breast reconstruction requires further definition.
Purpose of the Study:
- To systematically review and meta-analyze the effectiveness and safety of HBOT in the early postoperative phase of first-stage breast reconstruction.
Main Methods:
- A PRISMA-compliant systematic search was conducted across multiple databases up to October 2025.
- Included studies involved adults undergoing breast reconstruction receiving HBOT for postoperative ischemia or necrosis.
- Meta-analyses were performed for clinical endpoints, with quality assessed using MINORS and Murad et al. frameworks, and certainty evaluated using GRADE.
Main Results:
- Five observational studies (409 patients, 75 receiving HBOT) were included; therapy typically started within 10 days post-op.
- Pooled estimates showed high flap (82%) and pocket (78%) salvage rates with HBOT.
- Reoperation (15%), explantation (8%), and infection (3%) rates were reported, with mild adverse events.
Conclusions:
- Current evidence suggests HBOT is a safe and potentially beneficial adjunct for managing ischemic complications in breast reconstruction.
- The findings are limited by small, observational studies and low certainty of evidence.
- Further high-quality prospective and randomized trials are necessary to establish the optimal role of HBOT.
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