ReviewJPRAS open2026
Beyond expansion: the strategic role of the tissue expander in immediate breast reconstruction.
Review in JPRAS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImmediate tissue expander breast reconstruction remains widely used after mastectomy, but its contemporary role extends beyond progressive skin-envelope expansion. By providing adjustable volume and tension control, accommodating oncological sequencing, and preserving future reconstructive options, the tissue expander may serve as a strategic tool when the definitive reconstructive pathway remains uncertain. This focused narrative review evaluates the factors guiding immediate reconstructive strategy, integration with postmastectomy radiotherapy (PMRT), comparison with direct-to-implant (DTI) reconstruction, and the role of tissue expanders in delayed-immediate reconstruction.
methodsA structured literature search of PubMed/MEDLINE and Embase identified publications from January 2010 to June 2026. Systematic reviews, meta-analyses, comparative cohorts, multicentre studies, and studies reporting patient-reported outcomes were prioritised and synthesised thematically around four predefined clinical questions.
resultsNo reconstructive strategy demonstrates universal superiority. DTI provides an efficient definitive option when breast anatomy, tissue conditions, patient risk profile, and the oncological pathway are favourable and predictable. Tissue expander reconstruction offers greater adjustability when these conditions are less favourable or remain uncertain. In patients receiving PMRT, irradiation of the expander is associated with a higher risk of reconstructive failure, whereas irradiation of the permanent implant is associated with more severe capsular contracture; however, prospective multicentre studies have not consistently demonstrated differences in failure after adjustment for confounding factors. Delayed-immediate reconstruction preserves the breast envelope and maintains both implant-based and autologous options while definitive treatment is clarified, although the additional expander stage introduces specific morbidity and resource utilisation.
conclusionsTissue expander reconstruction should not be regarded as a default intermediate step or a universally safer alternative to definitive reconstruction. Its contemporary value lies in preserving reconstructive flexibility when anatomical, oncological, or patient-related factors make immediate commitment to a definitive strategy less appropriate. Future studies should identify the patients in whom this adjustability translates into meaningful clinical benefit.
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What OpenQuestion holds
Registered trials
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.