Long-term aesthetic outcomes of reconstructive surgeries with implant-based reconstruction in combination with a thoracodorsal flap, performed for breast cancer

The purpose of this article is to evaluate the long-term aesthetic and functional results of breast reconstruction using a combination of an endoprosthesis and a thoraco-dorsal flap (TDL) in breast cancer survivors. The study included 35 patients divided into two groups: 20 with one-stage reconstruction (implant with TDL) and 15 with two-stage reconstruction (expander, then implant with TDL) who underwent reconstructive surgery for soft tissue deficiency and as part of a comprehensive treatment including radiation therapy to reduce the risk of recurrence. Surgery was performed in one or two stages to compare the efficacy of the two approaches. Outcomes were assessed using a questionnaire that included cosmetic and psychological aspects. The mean follow- up was 10.7 years (6 to 15.5 years). Of the total, 24 patients underwent radiotherapy to study its effect. The main objective was to compare the effectiveness of the methods and their results. The results obtained indicate a high level of patient satisfaction with the cosmetic and functional parameters of the reconstruction, including the naturalness of the shape and symmetry of the breast. The use of the TDL flap significantly improved aesthetics and reduced the risk of complications such as capsular contracture and flap necrosis. Most importantly, the combined approach using the TDL flap showed benefits in the setting of radiation therapy, which contributed to improved long- term outcomes and reduced complication rates.