[The immediate breast reconstruction].

Authors

B Couturaud, A Bazeli, E Laas, T Gaillard, L Darrigues

Published in

Annales de chirurgie plastique et esthetique. Volume 71. Issue 6. Pages 581-590.

Abstract

Breast cancer remains a major public health issue, with increasing incidence in France despite a steady decline in mortality. Immediate breast reconstruction (IBR), although still underutilized, is now considered a standard component of care for patients undergoing mastectomy. This article provides an overview of the indications and strategies for IBR. After reviewing the main histological subtypes and the growing role of neoadjuvant therapies, it highlights the importance of preoperative assessment and multidisciplinary team discussion. Surgical planning is based on a detailed morphological evaluation, guiding decisions regarding nipple-areola complex preservation, incision approach, and reconstructive technique. Implant-based reconstruction is generally preferred in straightforward cases, whereas autologous reconstruction remains the gold standard in more complex situations, particularly in patients with ptosis, prior irradiation, or significant risk factors. Specific clinical scenarios, including local recurrence, bilateral breast cancer, and two-stage strategies, require tailored approaches. The optimal timing of radiotherapy in relation to reconstruction remains a subject of ongoing debate. IBR should therefore be considered a personalized surgical approach, integrated into multidisciplinary care, aiming to ensure oncological safety while optimizing aesthetic outcomes and patient quality of life.

PMID:
43014841
Bibliographic data and abstract were imported from PubMed on 12 Nov 2026.

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