Background/Objectives: Prophylactic mastectomy can significantly reduce the risk of breast cancer in patients carrying gene mutations such as BRCA1 and BRCA2. Patients who opt for breast removal are offered tailored reconstructive options based on their medical history and prior treatments, and in these often young patients with limited autologous tissue reserves, implant-based reconstruction is frequently the option of choice. Complication rates of these procedures are relatively high and account for up to 30%. Subcutaneous mastectomy with primary implant reconstruction carries risks such as hematoma, seroma, skin necrosis, necrosis of the nipple–areola complex, and wound healing issues, which may necessitate revision surgery. This university-center retrospective analysis aims to improve outcomes by identifying patient- and surgery-related risk factors associated with postoperative complications in allogenic breast reconstruction following subcutaneous mastectomy. Methods: We analyzed 61 female patients and 122 breasts who underwent primary implant-based reconstruction after skin- or nipple-sparing subcutaneous mastectomy over three years between January 2021 and December 2023. Demographic and surgical variables were systematically collected and analyzed. Results: The mean patient age was 41.5 ± 10.3 years. A total of 13% of patients were active smokers, and 1.6% had diabetes mellitus. Overall, skin flap necrosis occurred in 27.9% of patients (22.1% of breasts), wound healing disorders in 19.7% of patients, wound infections in 9.8%, and revision surgery in 18.0%. A history of pregnancy was associated with skin flap necrosis (OR 10.07, 95% CI 1.79–190.06; p = 0.032); however, this finding must be interpreted with caution due to limited statistical power and model instability. Conclusions: This investigation revealed clinically relevant patterns suggesting potential risk factors for wound healing disorders and skin necrosis. Prospective studies are planned to further substantiate these findings and to help reduce overall complication rates associated with the procedure.

Background/Objectives: Breast cancer is the most common cancer among women worldwide. Surgical treatments include breast-conserving therapy (BCT) and mastectomy, often followed by reconstruction, but the impact of reconstruction on locoregional recurrence (LRR) remains unclear. This study evaluated LRR, survival, and risk factors following primary breast reconstruction performed simultaneously with mastectomy compared with mastectomy without reconstruction. Methods: This population-based, retrospective cohort included 2475 women with breast cancer treated between 2004 and 2018 at the Tumor Center and Caritas St. Josef Hospital in Regensburg, Germany. Patients were grouped into not primarily reconstructed, primary autologous reconstruction, primary allogeneic reconstruction, and primary combined reconstruction. Overall survival (OS), recurrence-free survival (RFS), and cumulative recurrence rates (CRR) were assessed using Kaplan–Meier methods and Cox proportional hazards models adjusted for age, nodal status, tumor biology, and adjuvant therapies. Results: Of 14,046 eligible cases, 2475 met inclusion criteria: no primary reconstruction (87%), autologous reconstruction (3.1%), allogeneic reconstruction (9.0%), and combined reconstruction (0.4%). Patients undergoing reconstruction were younger and more likely to receive chemotherapy. The 5-year OS was 71.8% without primary reconstruction, 82.1% after autologous reconstruction, and 90.0% after allogeneic reconstruction. Allogeneic reconstruction was associated with improved OS (HR 0.570, p = 0.015) and RFS (HR 0.669, p = 0.039), whereas autologous reconstruction was associated with higher hazards of LRR and distant metastases compared to no primary reconstruction. Conclusions: The 5-year cumulative LRR was 5.2%, 13.5%, and 4.8%, respectively. Immediate allogeneic reconstruction after mastectomy was therefore associated with favorable survival and recurrence outcomes, while autologous reconstruction was linked to higher LRR and distant metastasis rates in this cohort. The retrospective design, small autologous subgroup, and absence of detailed lifestyle and metabolic data are important limitations of these findings. These associations likely reflect differences in tumor stage, biology, and unmeasured risk factors, and should be interpreted as hypothesis generating. Prospective multicenter studies with detailed risk profiling are needed to clarify the oncologic safety of different reconstructive strategies.

Peripheral nerve injuries (PNI) present a major clinical and socioeconomic challenge due to limited regenerative capacity. Adipose-derived stem cells (ADSCs) within the stromal vascular fraction (SVF) of white adipose tissue offer a promising autologous source for regenerative support. This study evaluated the impact of mechanical processing CELT (Cell-Enriched Lipotransfer) and CELT^PLUS and electrical stimulation on the regenerative secretome of human lipoaspirates. qPCR analysis revealed that CELT^PLUS processing, which incorporates mechanical intersyringe shifting, significantly doubled the gene expression of nerve growth factor (NGF) (p = 0.015), vascular endothelial growth factor (VEGF) (p = 0.02), and brain-derived neurotrophic factor (BDNF) (p = 0.04) compared to CELT-processed lipoaspirate. Protein analysis via ELISA confirmed a time-dependent secretion of NGF and VEGF over 96 h. Furthermore, 24 h electrical stimulation (2 V) significantly enhanced NGF protein release (p < 0.001). These findings demonstrate that standardized mechanical processing effectively enriches regenerative cell populations and amplifies their neurogenic and angiogenic potential. The additional modulation of growth factor secretion via electrical stimulation highlights the potential of processed adipose tissue as a functional, autologous transplant for enhanced nerve reconstruction.

Despite trans-tibial amputation being the most common major amputation, consensus on optimal stump management remains limited. Cohort studies comparing Ertl-tibiofibular synostosis (TFS) and Burgess-type stumps (BTS) have yielded conflicting results. We present the case of a bilateral trans-tibial amputee with a modified TFS on the right and a conventional BTS on the left. Instead of traditional myodesis, a myoplastic sling was created attaching residual tendons distal to the bone bridge to improve tendon sliding and perceptive feedback. Outcomes were assessed via load distribution, temporospatial gait analysis, adaptability tests, postural control studies, the Four Square Step Test (FSST), stair ascent, functional MRI, and tractography. The TFS stump appeared to show greater ambulation efficiency and was preferred during prolonged standing. FSST and circular gait tests revealed unsteadiness on the BTS side. No activated voxels appeared in the left postcentral gyrus during BTS loading. Movement of the TFS stump activated larger clusters in the contralateral precentral gyrus, while BTS movement activated the supplementary motor area. Fiber connections to the cerebellum via the superior cerebellar peduncle yielded more extensive streamline reconstructions during BTS movement. These unique trial conditions highlight subtle functional differences that are often missed in cohort studies but may significantly impact individual patient needs.