A.Kh. Ismagilov1, 2, N.E. Manturova3, A.V. Pushkarev4, A.S. Vanesyan5
1Kazan State Medical Academy — Branch Campus of the FSBEI FPE RMACPE MOH Russia, Kazan
2Republican Clinical Oncological Dispensary, Kazan
3N.I. Pirogov Russian National Research Medical University, Department of Plastic and Reconstructive Surgery, Cosmetology and Cellular Technologies, Moscow
4Republican Oncological Dispensary, Ufa
5Catalan Institute of Health, Pura Fernández Emergency and Primary Care Center, Barcelona, Spain
Vanesyan A.S. — PhD (Medicine), Breast Surgeon
135, Cobalt St., 08820 Barcelona, tel.: +34651638304, e-mail: anna_vanesyan@yahoo.com, ORCID ID: 0000-0002-1113-6320
Abstract. Breast cancer remains a leading cause of cancer-related mortality among women despite significant advancements in diagnosis and treatment. Surgical intervention continues to form the cornerstone of therapy, while reconstructive plastic surgery of the breast has become an integral component of a comprehensive, multidisciplinary approach. Over the past few decades, reconstructive strategies have evolved from radical mastectomy to breast-conserving surgery and skin-sparing techniques, including nipple-sparing mastectomy. These approaches aim to maximize preservation of the anatomical and aesthetic structures of the breast without compromising oncological safety.
This article discusses current trends in breast reconstruction, including the selection of implant placement planes (prepectoral, subpectoral, dual-plane), direct-to-implant procedures, and the use of both biological and synthetic matrices. Special emphasis is placed on acellular dermal matrices (ADM), which have demonstrated efficacy in improving reconstructive shape and structural stability.
Recent adjunctive techniques are also reviewed, such as the use of botulinum toxin type A and autologous fat grafting (lipofilling), both of which contribute to reduced postoperative pain and enhanced aesthetic outcomes. Additionally, the article describes innovative technologies — including endoscopic and robot-assisted procedures — that provide high precision while minimizing surgical invasiveness.
Thus, breast reconstructive surgery is increasingly moving toward personalized, precision-based, and minimally invasive approaches aimed at optimal restoration of breast appearance and improved quality of life for patients.
Key words: breast reconstruction, skin-sparing mastectomy, prepectoral breast reconstruction, acellular dermal matrices.