Background: Tuberous breast deformity (TBD) is a congenital condition characterized by constriction of the breast base, parenchymal hypoplasia, and areolar herniation. The absence of a universally accepted classification system complicates diagnosis and surgical planning, leading to variability in clinical outcomes. Artificial intelligence (AI) has emerged as a powerful adjunct in medical imaging, enabling objective, reproducible, and data-driven diagnostic assessments. Objectives: This study introduces an AI-driven diagnostic tool for TBD classification using a Siamese network trained on paired frontal and lateral images. Additionally, the model generates a continuous Tuberosity Score (ranging from 0 to 1) based on embedding vector distances, offering an objective measure to enhance surgical planning and improved clinical outcomes. Methods: A dataset of 200 expertly classified frontal and lateral breast images (100 tuberous, 100 non-tuberous) was used to train a Siamese network with contrastive loss. The model extracted high-dimensional feature embeddings to differentiate tuberous from non-tuberous breasts. Five-fold cross-validation ensured robust performance evaluation. Performance metrics included accuracy, precision, recall, and F1-score. Visualization techniques, such as t-distributed Stochastic Neighbor Embedding clustering and occlusion sensitivity mapping, were employed to interpret model decisions. Results: The model achieved an average accuracy of 96.2% ± 5.5%, with balanced precision and recall. The Tuberosity Score, derived from the Euclidean distance between embeddings, provided a continuous measure of deformity severity, correlating well with clinical assessments. Conclusions: This AI-based framework offers an objective, high-accuracy classification system for TBD. The Tuberosity Score enhances diagnostic precision, potentially aiding in surgical planning and improving patient outcomes.

Background: Pre-pectoral direct-to-implant breast reconstruction is increasingly adopted after mastectomy because it avoids pectoralis major dissection, reduces postoperative pain, and eliminates animation deformity. However, reconstruction in patients with large or markedly ptotic breasts remains challenging because of skin envelope management, nipple–areola complex (NAC) viability, and implant stability. This study evaluated batwing skin-reducing mastectomy with immediate pre-pectoral polyurethane-coated implant reconstruction. Methods: We conducted a retrospective single-center study of consecutive patients who underwent batwing skin-reducing mastectomy with immediate pre-pectoral polyurethane-coated implant reconstruction between November 2022 and January 2025. Demographic, oncologic, operative, postoperative, and BREAST-Q data were collected. Primary outcomes included complications, oncologic events, and 12-month patient-reported outcomes. Results: Thirteen patients underwent reconstruction, accounting for 18 breasts, with a mean follow-up of 12.85 months. Mean age was 54.5 ± 9.7 years, mean body mass index was 27.0 ± 3.4 kg/m², and mean Regnault ptosis grade was 3.46 ± 0.52. No seromas or oncologic recurrences were observed. One hematoma and one late infection requiring implant removal occurred. Superficial NAC/central flap epidermolysis developed in four patients and resolved conservatively; no full-thickness NAC necrosis occurred. BREAST-Q scores improved significantly in all domains at 12 months, including satisfaction with breasts, psychosocial well-being, physical well-being, and sexual well-being (all p < 0.05). Conclusions: Batwing skin-reducing mastectomy with immediate pre-pectoral polyurethane implant reconstruction appears safe and reproducible in selected patients with advanced ptosis, with acceptable complication rates and significant improvement in patient-reported outcomes.

Background: Breast surgery, both aesthetic and reconstructive, has evolved significantly over the years. Postoperative care is vital for patient recovery, with surgical dressings playing a crucial role in minimizing complications, including infections and bleeding. This review aims to evaluate the safety, comfort, and effectiveness of different durations for wearing surgical dressings after breast surgery. It also explores the use of negative pressure wound dressings and postoperative bras to enhance surgical outcomes. Methods: A comprehensive review of literature published from 2003 to 2024. Studies focusing on breast dressing techniques after mammary reconstruction and aesthetic surgery in plastic surgery were included. Results: Of 1503 initially identified articles, 12 were deemed relevant and included in this review. The findings suggest that prolonged dressing wear, up to 6 days postsurgery, may reduce cutaneous colonization without affecting infection rates in aesthetic breast surgery. Additionally, negative pressure wound therapy demonstrates promise in reducing overall wound complications and mastectomy flap necrosis. The utilization of specific postoperative bras is shown to improve patient comfort, mobility, and security, contributing to pain reduction and aesthetic outcomes. Conclusions: The lack of consensus on dressing selection and duration calls for further research in breast surgery postoperative care. Extended dressing wear, negative pressure therapy, and customized postoperative bras show potential in reducing complications, providing new avenues to enhance patient outcomes in the field of plastic surgery. Addressing these issues can lead to improved patient satisfaction and surgical results.

Background: Postoperative breast edema is a frequent sequela following mastectomy with implant-based reconstruction and may negatively affect recovery, comfort, and quality of life. Breast taping has been proposed as a supportive strategy to enhance lymphatic drainage and reduce edema; however, evidence in the context of breast reconstruction remains limited. Objectives: To evaluate, in a pilot randomized controlled setting, whether breast taping applied as an adjunct to standard postoperative care reduces breast edema after mastectomy with immediate implant-based reconstruction, as assessed by ultrasound-measured mastectomy flap thickness and patient-reported edema-related symptoms, and to generate preliminary efficacy and effect-size estimates to inform future confirmatory trials. Methods: This single-center randomized controlled trial included women undergoing unilateral or bilateral mastectomy with immediate implant-based reconstruction. Patients were randomized to receive standard postoperative care alone (control) or standard care plus breast taping (experimental). Breast taping was initiated 1 week postoperatively and maintained for 14 days. Patients were followed for 2 months. The primary outcome was mastectomy flap thickness assessed by serial ultrasound examinations. Secondary outcomes included patient-reported breast edema–related symptoms measured using the Breast Edema Questionnaire (BrEQ). Between-group comparisons were performed at weeks 4 and 8. Results: Fourteen patients were equally allocated between groups. Throughout follow-up, mean mastectomy flap thickness was consistently lower in the experimental group. A significant between-group difference in flap thickness change was observed from week 1 to week 4 (ΔT4–T1; P = 0.014), reflecting a reduction in the taping group and an increase in controls. Although differences at later time points were not statistically significant, BrEQ scores improved more rapidly and persistently in the experimental group, with significant between-group differences at week 4 (P = 0.0033) and week 8 (P = 0.018). Conclusions: Breast taping represents a safe, simple adjunct to standard postoperative care that may help facilitate reduction of breast edema and yields sustained improvements in patient-reported symptoms following implant-based breast reconstruction. Larger, multicenter studies with longer follow-up are warranted to validate these preliminary findings.