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J Reconstr Microsurg
DOI: 10.1055/a-2717-4314
Original Article

Mix and Match: Enhancing Microsurgical Breast Reconstruction Outcomes with Hybrid Techniques

Authors

  • Anna E. Daytz 

    1   Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States

  • Jina Yom

    1   Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States

  • Christopher Aiello

    2   Department of Plastic and Reconstructive Surgery, Northwell Health, Great Neck, New York, United States

  • Darren L. Sultan

    2   Department of Plastic and Reconstructive Surgery, Northwell Health, Great Neck, New York, United States

  • Raquel A. Minasian

    2   Department of Plastic and Reconstructive Surgery, Northwell Health, Great Neck, New York, United States

  • Isabelle T. Smith 

    2   Department of Plastic and Reconstructive Surgery, Northwell Health, Great Neck, New York, United States

  • Ashley M. Howell

    3   Department of Plastic and Reconstructive Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States

  • Mark L. Smith

    2   Department of Plastic and Reconstructive Surgery, Northwell Health, Great Neck, New York, United States

  • Neil Tanna

    2   Department of Plastic and Reconstructive Surgery, Northwell Health, Great Neck, New York, United States
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Abstract

Background

Hybrid breast reconstruction can alleviate the discordance between donor flap and desired breast volume in patients previously excluded from flap-based modalities. The authors review their consecutive experiences with two novel hybrid microsurgical breast reconstruction techniques.

Methods

A review of all consecutive patients who received microsurgical flap reconstruction was performed over a 5-year period, both with and without hybrid techniques. The HyPAD® technique combines flap reconstruction with stacked prepectoral acellular dermal matrix (ADM), while the HyFIL® technique combines a flap, prepectoral implant, and fat transfer (lipofilling). Demographic, health-related, surgical, and outcome indicators were measured for comprehensive qualitative and quantitative analysis.

Results

During the study period (2018–2023), 101 patients with hybrid breast reconstruction (HyPAD® n = 40, HyFIL® n = 61) were compared with 208 patients who received DIEP flap reconstruction alone. Hybrid patients were significantly younger (47.3 versus 52.9 years, p < 0.01), had lower BMIs (24.9 versus 30.3 kg/cm2, p < 0.01), and had reduced mastectomy weights (452.1 versus 652.0 g, p < 0.01) and flap weights (348.7 versus 683.5 g, p < 0.01). Hybrid patients had fewer clinically significant readmissions after discharge (1 versus 15, p = 0.02). No significant differences were found for length of stay of index admission (p = 0.56) or returns to the operating room upon index admission (p = 0.64). No implant or ADM extrusions occurred in the hybrid cohort.

Conclusion

Hybrid microsurgical breast reconstruction is a safe and reliable method to enhance core projection and volume.

Keywords

acellular dermal matrix - hybrid - breast reconstruction


Publication History

Received: 11 April 2025

Accepted: 21 September 2025

Accepted Manuscript online:
09 October 2025

Article published online:
07 November 2025

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