The articles with a higher level of evidence are, on average, cited more often than those with low levels of evidence in the leading journals of plastic surgery.
Breast reconstruction has evolved over the last century, especially with the advent of new technologies including anatomical implants, expanders, and, most recently, acellular dermal matrix. The development of techniques ranging from free/pedicle flaps, implant-based reconstruction, fat grafting, and oncoplastic surgery have also played a major part in the success of this field. It is important that patients are informed about the possibility of having some type of reconstructive surgery in a second stage. The surgery should be performed by someone with the required training, either a plastic or oncoplastic surgeon, and this is an important quality assurance issue for the patient. Immediate breast reconstruction is gaining wide acceptance. However, secondary reconstruction is also a valid instrument, and in many cases, it is a reference standard procedure.
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