Objectives: - Describe options for post-mastectomy breast reconstruction
- Systematically analyze breast deformities after primary reconstruction
- Categorize and describe options for deformities after implant-based reconstruction
- Categorize and describe options for deformities after autologous reconstruction

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Objectives: Review long term outcomes following prefectoral breast reconstruction

Introduction: Introduction: Prepectoral placement of prosthetic devices has become the preferred method for breast reconstruction. This presentation will review the long-term surgical and aesthetic outcomes.

Materials / method: Methods: In a review of our first 90 patients (139 breasts), we analyzed preoperative and postoperative breast symmetry, rippling, edge visibility, and capsular contracture. Follow-up for all patients ranged from at least 1 year up to a maximum of 4.3 years. Secondary procedures such as fat grafting, implant exchange, contralateral procedures, and autologous flap conversion were reviewed.

Results: Results: Breast symmetry noted preoperatively in 84.4% of patients but gradually declined to 68.9% after 1 to 2 years and to 56.7% after 2 to 5 years. Rippling and edge visibility was noted in 19.4% and 12.9% of patients, respectively. Explantation without replacement of the device was performed in 12 breasts (8.6%). Secondary procedures included autologous fat grafting (23.7%), implant replacement (7.2%), conversion to an autologous flap (12.2%), and a contralateral breast procedure in 15 of 41 patients (36.6%). Capsular contracture (grade 3-4) was demonstrated in 14 of 139 breasts (10.1%); h

Conclusion: Conclusions: Prepectoral breast reconstruction can provide good to excellent short-term (1-2 years) and longer-term (2-4.3 years) benefits; however, over time, the quality of prepectoral breast reconstruction as well as breast symmetry can change due to various factors.

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Objectives: To know all the possibilities the fat grafts provide to the plastic surgeon to reconstruct the breast and achievement of the best results in terms of aesthetics and functionality.

Introduction: Fat grafting has experienced an exponential growing in the field of breast reconstruction in the last decade and alongside the perforator flaps represent the main actors of the breast reconstruction of the present millennial.

Materials / method: Since year 2007, fat grafting has been applied in our breast reconstruction patients in different indications. The early results encouraged us to spread their application to most of our patients and to study their safety.

Results: Almost 100% of our patients receive a fat graft at some point of their reconstructive process. This can be used for reconstruction used alone for mastectomy reconstruction, LD muscle flap enhanced with fat, partial defects (BC surgery) restoration, as an ancillary procedure of any other type of reconstruction (direct to implant, two steps with expander, microsurgical or pedicled flap...). Depending of the indication is used as immediate reconstruction or delayed.
The main indication, given it has no rival, is on partial defects. Two publications of our team confirm its oncological safety.

Conclusion: Fat grafting is a versatile procedure to safely reconstruct or achieve the best results in breast reconstruction. Other procedures can benefit of it to reach the goal of full restoration.

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