The traditional view is that breast reconstruction is not an option for day surgery center. As a result, few hospitals in the world conduct this operation in day surgery center. Endoscopic breast reconstruction with liposuction and robot-assisted breast reconstruction are minimally invasive surgeries for breast cancer patients, but they cannot be carried out in the day surgery center due to long operation time. The novel endoscopic-assisted immediate implant-based breast reconstruction after nipple sparing mastectomy through a single axillary incision for breast cancer patients has been successfully conducted in the day surgery center in our hospital due to short operation time and small trauma. Standardized management of the complete process from the patient selection to follow-up after discharge brings rapid recovery and few complications. At the same time, the development of endoscopic surgery makes the breast almost scarless and improves aesthetic results. Therefore, the mode of endoscopic-assisted reconstruction in the day surgery center of our hospital is expected to be popularized in the whole country.
Objective To explore the current status and advances of tissue expansion technology in post-mastectomy breast reconstruction, and to provide references for the rational selection of expander types, implant planes, and strategies for complication prevention and management in clinical practice. MethodsAn extensive review was conducted on relevant literature and clinical research data, both domestic and international, from recent years regarding tissue expansion techlology for breast reconstruction following mastectomy. The focus was on summarizing the characteristics and indications of different types of expanders, outlining the advantages and disadvantages of the two implant planes, subpectoral and prepectoral, and discussing the prevention and management of common complications. Results Tissue expanders continue to serve as a pivotal element in breast prosthesis reconstruction, with their effectiveness being subject to the influence of multiple factors, including expander type, filling medium, implant plane, and individual patient characteristics. In recent years, research endeavors have concentrated on prepectoral placement, the selection of expanders with varying surface properties, and a comparative analysis between air and saline filling techniques. Notably, different technical strategies demonstrate distinct variations in terms of postoperative pain, seroma, infection, and capsular contracture. ConclusionTissue expansion technology has become a cornerstone of implant-based breast reconstruction after mastectomy. Each expander type, filling method, and implant plane has its own advantages and limitations; selection should be tailored to the patient’s anatomical condition, oncologic treatment plan, and individualized aesthetic requirements.