Current evidences on immediate breast reconstruction after mastectomy

Immediate breast reconstruction after mastectomy is widely used: the introduction of skin sparing and nipple sparing mastectomy (NSM) have broaden the viability of different techniques either prosthetic either autologous one. In prosthetic reconstruction, expander is in some case still used, even if one stage reconstruction is preferred. The prosthetic reconstruction is preferred in small breast with minimal/no ptosis and in bilateral cases. The authors explain the different techniques for direct to implant reconstruction: submuscular-subfascial pocket and use of acellular dermal matrix (ADM) (either in subpectoral either in prepectoral plane). The autologous reconstruction is preferred in patients with large breast or with previous radiotherapy. Abdominal flaps are the workhorse because the can provide for large volume flaps and because of the better cosmetic results, even if flaps from areas are available.