Artificial intelligence (AI) has the potential to transform preoperative planning for breast reconstruction by enhancing the efficiency, accuracy, and reliability of radiology reporting through automatic interpretation and perforator identification. Large language models (LLMs) have recently advanced significantly in medicine. This study aimed to evaluate the proficiency of contemporary LLMs in interpreting computed tomography angiography (CTA) scans for deep inferior epigastric perforator (DIEP) flap preoperative planning. Four prominent LLMs, ChatGPT-4, BARD, Perplexity, and BingAI, answered six questions on CTA scan reporting. A panel of expert plastic surgeons with extensive experience in breast reconstruction assessed the responses using a Likert scale. In contrast, the responses’ readability was evaluated using the Flesch Reading Ease score, the Flesch-Kincaid Grade level, and the Coleman-Liau Index. The DISCERN score was utilized to determine the responses’ suitability. Statistical significance was identified through a t-test, and P-values < 0.05 were considered significant. BingAI provided the most accurate and useful responses to prompts, followed by Perplexity, ChatGPT, and then BARD. BingAI had the greatest Flesh Reading Ease (34.7±5.5) and DISCERN (60.5±3.9) scores. Perplexity had higher Flesch-Kincaid Grade level (20.5±2.7) and Coleman-Liau Index (17.8±1.6) scores than other LLMs. LLMs exhibit limitations in their capabilities of reporting CTA for preoperative planning of breast reconstruction, yet the rapid advancements in technology hint at a promising future. AI stands poised to enhance the education of CTA reporting and aid preoperative planning. In the future, AI technology could provide automatic CTA interpretation, enhancing the efficiency, accuracy, and reliability of CTA reports.

Background: Thoracic air complications after autologous breast reconstruction (ABR) are uncommon and incompletely characterised. A personalised perioperative approach requires integration of patient anatomy, reconstructive technique, anaesthetic exposures and the postoperative clinical trajectory rather than reliance on population-level estimates alone. Methods: We report a 41-year-old woman in whom pneumomediastinum was identified after bilateral DIEP flap reconstruction and performed a focused literature review restricted to primary studies of pneumothorax or pneumomediastinum following autologous flap breast reconstruction. Searches across MEDLINE-Ovid, PubMed and Wiley Online Library using predefined MeSH terms were conducted. Data extraction focused on study characteristics, incidence, mechanism of injury, perioperative factors, and management. Results: The patient developed postoperative hypotension and persistent tachycardia, followed by pleuritic chest pain. CT excluded pulmonary embolism and oesophageal perforation but demonstrated Moderate volume pneumomediastinum without pneumothorax. She was managed conservatively and discharged on postoperative day 7. Five primary studies met the eligibility criteria. Study-specific pneumothorax frequencies were 1/463 (0.22%) after rib-sparing free-flap reconstruction, 3/749 (0.4%) after extended latissimus dorsi reconstruction, and 4/180 patients (2.2%; 1.4 per 100 internal mammary vessel dissections). Reported mechanisms included pleural injury during internal mammary vessel dissection, inadvertent puncture during regional anaesthesia, barotrauma under positive-pressure ventilation, and drain-related barotrauma. No previous primary report of pneumomediastinum after autologous flap breast reconstruction was identified. Conclusions: Pneumothorax and pneumomediastinum are uncommon but potentially serious complications of ABR. They are rarely documented postoperatively; however, surgeons and anaesthetists must remain vigilant, particularly during exposure of the internal mammary vessels and airway management. Patient-specific assessment, symptom-directed imaging and multidisciplinary management may support early recognition to prevent morbidity and preserve the outcomes of reconstructive procedures.

Background/Objectives: Open fasciectomy is the standard treatment for Dupuytren’s disease, but recent Australian outcome data are scarce. This study assessed outcomes and predictors of recurrence after open fasciectomy at a tertiary centre. Methods: We retrospectively reviewed all open fasciectomy procedures for Dupuytren’s disease at Peninsula Health, Victoria (January 2023–October 2024). Data included contracture correction, functional scores (URAM, Southampton), recurrence at 6 and 12 months, complications, and demographic predictors. Appropriate statistical tests were used (significance: p < 0.05). Results: Among 152 procedures (mean age 63.8; 70.2% male), contracture correction was significant for all joints. URAM and Southampton scores improved by 15.3 and 7.6 points (p < 0.001). Complications (22.4%) were mainly transient neuropraxia. Recurrence was 10.5% at six months and 13.8% at twelve months. Smoking and female sex increased recurrence risk. Conclusions: Open fasciectomy provides effective correction, functional gain, and low early recurrence rates. Smoking and female sex predict recurrence, supporting tailored counselling and reaffirming open fasciectomy as the standard for advanced Dupuytren’s disease.