The aim of this study was to investigate the relationship between the collagen type I/III ratio and scarring in patients who underwent immediate reconstruction with the round block technique (RBT) after breast conservation surgery. Seventy-eight patients were included, and demographic and clinical characteristics were recorded. The collagen type I/III ratio was measured using immunofluorescence staining and digital imaging, and scarring was assessed using the Vancouver Scar Scale (VSS). The mean VSS scores were 1.92 ± 2.01 and 1.79 ± 1.89, as assessed by two independent plastic surgeons, with good reliability of the scores. A significant positive correlation was found between VSS and the collagen type I/III ratio (r = 0.552, p < 0.01), and a significant negative correlation was found between VSS and the collagen type III content (r = −0.326, p < 0.05). Multiple linear regression analysis showed that the collagen type I/III ratio had a significant positive effect on VSS (β = 0.415, p = 0.028), whereas the collagen type I and collagen type III content had no significant effect on VSS. These findings suggest that the collagen type I/III ratio is associated with scar development in patients undergoing RBT after breast conservation surgery. Further research is needed to develop a patient-specific scar prediction model based on genetic factors affecting the collagen type I/III ratio.

Postoperative scars inevitably occur after surgical procedures and can impact both aesthetic and functional aspects of healing. With advancements in medical research, various strategies have been developed to prevent and manage surgical scars. This review explores mechanisms of wound healing, the classification of postoperative scars, and the latest approaches in scar prevention and treatment. The wound healing process consists of the following phases: hemostasis, inflammation, proliferation, and maturation. Understanding this process is essential for effective scar management. Factors such as tension, infection, and individual patient characteristics can influence scar formation. Preventive strategies, including optimal suture techniques, taping methods, silicone therapy, and corticosteroid injections, have demonstrated significant benefits in minimizing scar severity. Additionally, advanced treatments such as laser therapy and surgical scar revision techniques, including Z-plasty and W-plasty, offer effective solutions for improving established scars. Relaxed skin tension lines in surgical planning also play a crucial role in minimizing scar prominence. Evidence suggests that a multidisciplinary approach that integrates prevention and treatment modalities can optimize wound healing and improve patient outcomes. Implementing these evidence-based strategies can significantly improve postoperative scar management, ultimately enhancing both functional and cosmetic results for patients.

Background Several oncoplastic approaches have been implemented in recent years to enhance cosmetic results and to reduce complications. The round block technique is a volume displacement technique for breast reconstruction after breast-conserving surgery (BCS). However, its indications are currently limited according to tumor location, and its cosmetic results and complications have not been clearly established. We hypothesized that the round block technique could produce favorable cosmetic results without major complications regardless of tumor location or nipple-tumor distance, below a certain resected tumor volume and tumor-breast volume ratio. Methods All breast reconstructions using the round block technique after BCS were included in this analysis. Patients’ data were reviewed retrospectively to investigate complications during follow-up, and clinical photos were used to evaluate cosmetic results. The relationships of tumor location, nipple-tumor distance, tumor volume, and the tumor-breast volume ratio with cosmetic results were investigated. Results In total, 108 breasts were reconstructed. The mean resected tumor volume was 30.2±15.0 mL. The cosmetic score was 4.5±0.6 out of 5. Tumor location, nipple-tumor distance, tumor volume, tumor-breast volume ratio, radiotherapy, and chemotherapy had no significant effects on cosmetic results or complications. There were no major complications requiring reoperation. Conclusions Breast reconstruction using the round block technique after BCS can lead to good cosmetic results without major complications regardless of the tumor location, nipple-tumor distance, radiotherapy, or chemotherapy. Below the maximum tumor volume (79.2 mL) and the maximum tumor-breast volume ratio (14%), favorable results were consistently obtained.

Background/Objectives: To quantitatively assess the long-term volume stability of acellular dermal matrix (ADM) in oncoplastic breast-conserving surgery (OBCS) and analyze surgical and aesthetic outcomes. Methods: This retrospective study examined 172 breast cancer patients who underwent OBCS with immediate ADM-based volume replacement (2020–2022). Patients received either diced ADM with sheet ADM (n = 102) or diced ADM with paste ADM (n = 70). The ADM volume was evaluated using MRI at 6, 12, and 24 months postoperatively. Results: Long-term volume stability was achieved in both groups with minimal volume reduction (4.3–4.5%) at 24 months (p < 0.001). Early surgical complications included hematoma (4.1%), seroma (2.3%), and wound issues (1.2%), with no infections or ADM non-incorporation. Contour irregularities occurred in 16.3% of cases. Radiotherapy (87% of patients) did not significantly impact ADM volume retention. Conclusions: ADM provides predictable, durable volume replacement in OBCS, with excellent volume stability even with radiotherapy. This quantitative assessment of ADM volume retention over two years supports ADM as a reliable option for breast-conserving surgery, potentially expanding treatment options for patients with unfavorable tumor-to-breast volume ratios.

The round block technique (RBT) is an oncoplastic surgery method that uses volume displacement techniques after partial mastectomy. However, cosmetic problems occur after tissue rearrangement in patients with small breasts or those in whom a large amount of breast tissue is excised. Therefore, we used an acellular dermal matrix (ADM) when the volume was insufficient after tissue rearrangement. Patients who underwent breast reconstruction using the ADM with the RBT after breast-conserving surgery (BCS) were included. The ADM graft was performed in two layers. First, it was placed on the glandular flap, and the patient was then seated to ascertain the degree of deformity. If the volume was insufficient, a graft was also performed under the skin flap. Overall, 107 oncoplastic surgeries were performed. Tumors were most commonly located in the upper outer quadrant of the breast, and the mean resected breast tissue was 27.1 g. Seroma was the most common complication, but it improved with several aspirations. There were no major complications or cosmetic problems requiring reoperation. Therefore, if the ADM was used for defects that could not be reconstructed with the RBT alone, safe and cosmetically good results could be obtained.

Oncoplastic breast-conserving surgery (OBCS) has revolutionized breast cancer treatment, aiming to achieve optimal oncological outcomes while preserving an aesthetically favorable appearance. This review explores the evolution, techniques, and outcomes of OBCS, with a particular focus on the emerging role of acellular dermal matrix in volume replacement techniques. We conducted a comprehensive literature review using PubMed, Medline, and Cochrane databases, focusing on studies published between 2010 and 2024. OBCS demonstrates comparable oncological safety to traditional breast-conserving surgery, with local recurrence rates ranging from 2.7% to 5.7% at 5 years. Patient satisfaction rates are consistently high, with 85% to 95% reporting good to excellent aesthetic outcomes. Volume replacement techniques using acellular dermal matrix show promising results, with one study reporting that 94% of patients were highly satisfied with cosmetic outcomes. Although the current results are encouraging, future advancements in OBCS may require innovative approaches, including the integration of robotic surgery and artificial intelligence technologies.