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Ewing et al. Plast Aesthet Res 2024;11:22 https://dx.doi.org/10.20517/2347-9264.2024.11 Page 11 of 15

CONCLUSION
While certain dogma has prevailed due to important data in our literature, advances in radiation and
multidisciplinary care have changed paradigms at certain institutions. With continued progress, derivation,
and innovation, plastic surgery and microsurgery are rapidly evolving. While the authors are not suggesting
that this is inevitable, plastic and reconstructive surgeons, along with patients and other healthcare
providers, must consider the possibility of paradigm shifts in breast reconstruction. This could mean a
change in microsurgical techniques, reconstructive timing, preoperative optimization, or postoperative
care [113,114] . Nonetheless, free tissue transfer will remain a vital reconstructive option not only for the breast,
but also for extremities and other body regions. Reconstructive surgeons must have an armamentarium
capable of these options for the best possible patient outcomes.

DECLARATIONS
Authors’ contributions
Made substantial contributions to the conception and design of the article and performed literature review
and interpretation: Ewing JN, Gala Z, Lemdani MS, Kovach III SJ, Azoury SC

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
Dr. Stephen Kovach is a consultant and speaker for Becton Dickinson, WL Gore and Company, Integra Life
Sciences, Checkpoint Surgical, and Abvie Consulting. Dr. Said C. Azoury serves as a Youth Editorial Board
member of the Plastic and Aesthetic Research (PAR) journal. All other listed authors declared that there are
no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2024.

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