{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T10:16:50Z","timestamp":1784888210737,"version":"3.55.0"},"reference-count":80,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T00:00:00Z","timestamp":1727136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Reconstructive plastic surgeons have made great strides in the field of breast reconstruction to achieve the best results for patients undergoing treatment for breast cancer. As microsurgical techniques have evolved, these patients can benefit from additional treatment modalities to optimize the results of the reconstruction. Free tissue transfer from alternative donor sites for breast reconstruction is routinely performed, which was not possible in the past. Neurotization is now possible to address the numbness and lack of sensation to the reconstructed breast. For those patients who develop lymphedema of the upper extremity as a result of their breast cancer care, supermicrosurgical options are now available to treat and even to prevent the development of lymphedema. This study presents a narrative review regarding the latest microsurgical advancements in autologous free flap breast reconstruction. Methods: A literature review was performed on PubMed with the key words \u201cautologous free flap breast reconstruction\u201d, \u201cdeep inferior epigastric perforator flap\u201d, \u201ctransverse upper gracilis flap\u201d, \u201cprofunda artery perforator flap\u201d, \u201csuperior gluteal artery perforator flap\u201d, \u201cinferior gluteal artery perforator flap\u201d, \u201clumbar artery perforator flap\u201d, \u201cbreast neurotization\u201d, \u201clymphovenous bypass and anastomosis\u201d, and \u201cvascularized lymph node transfer\u201d. Articles that specifically focused on free flap breast reconstruction, breast neurotization, and lymphedema surgery in the setting of breast cancer were evaluated and included in this literature review. Results: The literature search yielded a total of 4948 articles which were screened. After the initial screening, 413 articles were reviewed to assess the relevance and applicability to the current study. Conclusions: Breast reconstruction has evolved tremendously in recent years to provide the most natural and cosmetically pleasing results for those patients undergoing treatment for breast cancer. As technology and surgical techniques have progressed, breast cancer patients now have many more options, particularly if they are interested in autologous reconstruction. These advancements also provide the possibility of restoring sensibility to the reconstructed breast as well as treating the sequela of lymphedema due to their cancer treatment.<\/jats:p>","DOI":"10.3390\/jcm13195672","type":"journal-article","created":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T08:56:06Z","timestamp":1727168166000},"page":"5672","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Advances in Microsurgical Treatment Options to Optimize Autologous Free Flap Breast Reconstruction"],"prefix":"10.3390","volume":"13","author":[{"given":"Eric I.","family":"Chang","sequence":"first","affiliation":[{"name":"The Plastic Surgery Center, The Institute for Advanced Reconstruction, 535 Sycamore Avenue, Shrewsbury, NJ 07702, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"111e","DOI":"10.1097\/PRS.0000000000007480","article-title":"Latest advancements in autologous breast reconstruction","volume":"147","author":"Chang","year":"2021","journal-title":"Plast. 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