Objective To optimize the perioperative management experiences for breast cancer patients undergoing direct-to-implant-based breast reconstruction, and provide reference for clinical practice. Methods A comprehensive review of recent domestic and international literature was conducted to systematically summarize the key points of perioperative management for direct-to-implant-based breast reconstruction, including preoperative health education, intraoperative strategies, and postoperative management measures, along with an introduction to the clinical experiences of West China Hospital of Sichuan University. Results Standardized perioperative management can effectively reduce the incidence of complications and achieve excellent cosmetic outcomes and quality of life after operation. Preoperative management includes proactive health education to alleviate patients’ anxiety and improve treatment compliance, as well as comprehensive assessment by surgeons of the patient’s physical condition and reconstructive expectations to select the most appropriate implant. Intraoperative management consists of strict aseptic technique, minimizing implant exposure, preserving blood supply to the nipple-areola complex (e.g., by using minimally invasive techniques or indocyanine green angiography, etc), and meticulous hemostasis. Postoperative management encompasses multimodal analgesia, individualized drain management (such as early removal or retaining a small amount of fluid to optimize contour), infection prevention and control (including topical and systemic antibiotics, ultrasound-guided minimally invasive drainage), guidance on rehabilitation exercises (early activity restriction followed by gradual recovery), and regular follow-up to evaluate aesthetic results and monitor for complications. Conclusion Establishing a standardized, multidisciplinary perioperative management framework markedly enhances surgical safety and patient satisfaction, thereby providing a replicable benchmark for direct-to-implant-based breast reconstruction across diverse clinical settings.
Citation：
FENG Yu, ZHANG Donglin, LIANG Faqing, LUO Guilin, DU Zhenggui. Perioperative management of direct-to-implant-based breast reconstruction in breast cancer patients and West China Hospital experiences. Chinese Journal of Reparative and Reconstructive Surgery, 2025, 39(10): 1356-1362. doi: 10.7507/1002-1892.202505006
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Copyright © the editorial department of Chinese Journal of Reparative and Reconstructive Surgery of West China Medical Publisher. All rights reserved
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- 1. 刘威. 乳腺癌手术患者护理中应用心理干预的价值分析//四川省国际医学交流促进会. 医学护理创新学术交流会论文集 (创新医学篇). 2024. doi: 10.26914/c.cnkihy.2024.045542.
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- 21. Adams WP, Rios JL, Smith SJ. Enhancing patient outcomes in aesthetic and reconstructive breast surgery using triple antibiotic breast irrigation: six-year prospective clinical study. Plast Reconstr Surg, 2006, 118(7 Suppl): 46S-52S.
- 22. Adams WP. Commentary on: Surgical site irrigation in plastic surgery: what is essential? Aesthet Surg J, 2018, 38(3): 276-278.
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- 41. Dai H, Cao XM, Wu H, et al. Reverse-sequence endoscopic nipple-sparing mastectomy with direct-to-implant breast reconstruction and air inflation adjustment technique in patients with large or severely ptotic breast: a single-center prospective cohort study. Int J Surg, 2025, 111(6): 3838-3849.
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