Evidence map›Paper›PMID 40510435›Full record

ArticlePlastic and reconstructive surgery. Global open2025

Reverse Submammary Adipofascial Perforator Flap: Preliminary Results of a Dual-plane, Acellular Dermal Matrix-free, Direct-to-implant Hybrid Reconstruction.

Diego Ribuffo, Marco Marcasciano, Federico Lo Torto, Jacopo Nanni, Luca Patanè, Lorenzo Calabrese, Davide Marino, Donato Casella, Manfredi Greco

Abstract read
In one paragraph

Article in Plastic and reconstructive surgery. Global open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Applications of the Fold Flap in Breast Reconstruction.Plastic and reconstructive surgery. Global open · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Diego RibuffoFrom the Department of Surgery "P. Valdoni," Unit of Plastic and Reconstructive Surgery, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy.
Marco MarcascianoPlastic and Reconstructive Surgery Unit, Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, AOU Renato Dulbecco, Catanzaro, Italy.
Federico Lo TortoFrom the Department of Surgery "P. Valdoni," Unit of Plastic and Reconstructive Surgery, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy.
Jacopo NanniPlastic and Reconstructive Surgery Unit, Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, AOU Renato Dulbecco, Catanzaro, Italy.
Luca PatanèFrom the Department of Surgery "P. Valdoni," Unit of Plastic and Reconstructive Surgery, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy.
Lorenzo CalabreseFrom the Department of Surgery "P. Valdoni," Unit of Plastic and Reconstructive Surgery, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy.
Davide MarinoFrom the Department of Surgery "P. Valdoni," Unit of Plastic and Reconstructive Surgery, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy.
Donato CasellaDepartment of Breast Cancer Surgery, Azienda Ospedaliero-Universitaria Senese, Siena, Italy.
Manfredi GrecoDepartment of Surgery "P. Valdoni", "Sapienza" University of Rome, Plastic and Reconstructive Surgery Unit, "Santa Maria Goretti" Hospital, Latina, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Single-stage direct-to-implant (DTI) reconstruction, particularly the prepectoral technique, has become prominent due to its reliable outcomes and shorter operative time. This approach spares the pectoralis major muscle, reducing postoperative pain and morbidity, and ensuring quicker recovery. However, limitations such as patient comorbidities and tumor characteristics can limit feasibility, leading to complications and high reconstructive failure rates. In such cases, switching to autologous or 2-stage approaches becomes necessary. This study introduced an innovative acellular dermal matrix-free dual-plane DTI hybrid reconstruction using a reverse submammary adipofascial perforator flap for small-volume breasts. Methods: A prospective noncontrolled cohort study was conducted from January to April 2024, enrolling 10 breast cancer patients eligible for DTI reconstruction. Data collected included preoperative clinical characteristics, intraoperative surgical data, and postoperative outcomes, including complications and patient satisfaction measured using BREAST-Q version 2.0. Breast aesthetics was also evaluated by 12 independent observers at minimum 3 months follow-up. Results: The surgical technique involved a dual-plane pocket with a reverse submammary adipofascial perforator flap, harvested from the inframammary fold, anchored to the pectoralis major muscle for inferolateral pole coverage of the breast implant. Results showed 1 major complication requiring surgical revision and 1 minor skin flap necrosis managed conservatively. All patients reported good satisfaction with their reconstruction results, supported by positive aesthetic evaluations from observers. Conclusions: This acellular dermal matrix-free, dual-plane DTI hybrid technique seems safe and effective for small-volume breasts. It offers a viable alternative for selected cases, warranting further investigation with larger cohorts and longer follow-ups.

Identifiers

PMID40510435
PMCPMC12160741

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.