The role of indocyanine green angiography in implant-base breast reconstruction: A retrospective comparative study.

Reconstructive breast surgery, a critical procedure following mastectomy, depends on the accurate assessment of skin flap viability to reduce complications such as mastectomy skin flap necrosis (MSFN). Traditional clinical evaluations are subjective and may lead to misjudgment of tissue perfusion, contributing to suboptimal surgical outcomes. The advent of Indocyanine Green Angiography (ICGA) has introduced an objective, real-time method for evaluating perfusion. This retrospective comparative study investigated the outcomes of ICG angiography versus clinical assessment in implant-based breast reconstruction. The study involved 50 patients undergoing mastectomy with immediate reconstruction, categorized into two groups: Group A, where skin flap viability was assessed using ICGA, and Group B, where clinical assessments were used. Demographic data, surgical details, and complication rates were analyzed to evaluate the effectiveness of ICGA. Indocyanine Green Angiography (ICGA) proved valuable in identifying poorly perfused tissue intraoperatively, allowing surgeons to make timely adjustments and potentially reducing complications and re-intervention rates. Although Group A (ICGA) showed a lower overall complication rate (24 %) compared to Group B (36 %), most differences did not reach statistical significance and should be interpreted with caution. Significant associations were found between BMI, implant size, and prior breast surgeries with MSFN. The use of ICGA represents a promising, evidence-based adjunct for reconstructive breast surgery, offering a real-time perfusion assessment that may improve surgical decision-making, particularly in high-risk patients. Its routine use could enhance outcomes; however, larger prospective studies with sufficient power are needed to confirm these findings and generalize them to broader populations.