Reviewed by Reza Lankarani

This editorial addresses the critical debate surrounding the timing of contralateral symmetrization following therapeutic mammoplasty—a procedure combining oncologic resection with breast reshaping. The authors juxtapose immediate symmetrization (performed concurrently with cancer surgery) against delayed approaches (secondary procedures post-recovery). Traditional rationale for delaying symmetrization emphasizes allowing radiation-induced breast contraction to stabilize, thereby optimizing symmetry outcomes. However, the authors highlight significant drawbacks of delayed strategies: psychological distress (e.g., embarrassment, social withdrawal), increased costs (additional surgeries, prolonged care), and systemic inefficiencies (post-COVID-19 resource constraints).

Evidence from 1,130 patients across multiple studies supports the safety and efficacy of immediate symmetrization, with no increased complication rates or delays to adjuvant therapy. The authors’ institutional model—a dual-consultant, two-team approach—demonstrates cost savings (€5,500 per case) and enhanced surgical training opportunities. Patient acceptance of immediate symmetrization is high, with minimal need for revisional surgery. Despite this, surgical opinion remains divided (51% vs. 49% favoring immediate vs. delayed), underscoring a lack of robust comparative data on long-term outcomes.

https://open.substack.com/pub/lankarani/p/scholarly-review-and-commentary-symmetrization-in-therapeutic-mammoplasty-for-breast-cancer-9daa6a8d05e1?r=5h8lyl&utm_campaign=post&utm_medium=web&showWelcomeOnShare=false

Reza Lankarani M.D

#breastcancer #therapeuticmammoplasty #symmetrization #breastsurgery #breastreconstruction #oncoplasticsurgery #breastsymmetry #breastconservation #surgicaltechniques #breastcancertreatment #cosmeticbreastsurgery #tumorremoval #breasttumorsurgery #breastreconstructiontechniques #surgicalplanning

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