This collection of
Plastic and Reconstructive Surgery articles spanning January 2019 to June 2021 represents the “best of the best" in the breast plastic surgery literature. The articles have been chosen to cover hot topics relevant to practicing plastic surgeons, and each offers a unique contribution to the literature.
Highlights from the series include articles helping to define breast aesthetics, trial new technology, to assess long-term clinical and patient-reported outcomes, and address the opioid epidemic. Pietruski et. al use eye-tracking technology to identify the nipple-areolar complex and lower breast as key focus areas for breast attractiveness.1 To assess the outcomes between prepectoral and subpectoral breast reconstruction with acellular dermal matrix, Momeni et. al perform a matched study and show no difference in complication rates.2 Controversy remains regarding optimal choices for patients in breast reconstruction. In a retrospective comparative study, Schaverien et. al determine volume-replacement oncoplastic breast surgery has fewer procedures, complications, and time commitment compared to mastectomy and total breast reconstruction in their series.
The Mastectomy Reconstruction Outcomes Consortium (MROC) study prospectively gathered information on breast reconstruction outcomes to help address ongoing debates. For patients requiring post-mastectomy radiotherapy, questions remain on whether radiation should be delivered to the tissue expander or permanent implant. Yoon et al. show a similar rate of complications with radiation to either device4. To help counsel patients on revisional breast surgery, Nelson et. al report 40% of breast reconstruction patients undergo elective revisions.
Further controversy arises on whether contralateral prophylactic mastectomy should be performed at the time of therapeutic mastectomy. In their paper, Sharabi et. al show a low risk of complications in contralateral mastectomy and few delays to adjuvant treatment. For implant reconstructions that do fail, an analysis by Corridi et. al suggests that autologous reconstruction can provide a significant improvement in satisfaction with the breasts and quality of life.
The opioid epidemic has been linked to opioid prescribing practices. In their paper, Egan et. al show that breast reconstruction patients on average take only 57% of the prescribed pills, suggesting that practice guidelines may be changed to prescribe fewer opioids.
In review of the papers from the past 30 months, perhaps the most astonishing finding was the consistent and high-level of quality of all the papers published in
Plastic and Reconstructive Surgery. While this collection captures a group of excellent scientific discoveries, it by no means is meant to take away from the rest. We encourage the reader to review all the articles published in this time frame for the most up-to-date plastic surgery literature.
Amy S. Colwell, M.D. and Joseph J. Disa, M.D.Article Collection Co-Guest Editors
This Special Collection- and the Printed Edition that accompanies it- was made possible by a sponsorship from Mentor Worldwide LLC (Platinum Sponsor), Baxter_Synovis (Platinum Sponsor), MTF Biologics (Gold Sponsor), Sientra Inc. (Silver Sponsor).