Robot-Assisted Mastectomy and Immediate Microsurgical Breast Reconstruction

Robot-assisted mastectomy has emerged as an evolving technique in breast cancer surgery, with its advantage of improved visualization, precise dissection, and favorable aesthetic outcomes through limited hidden access. With proper patient selection, this approach has facilitated nipple-sparing mastectomy with good aesthetic outcome while maintaining oncologic safety. As an aesthetic outcome is one essential component of developing robot-assisted mastectomy, immediate breast reconstruction has been adapted to integrate with the procedure. While implant-based reconstruction remains the most commonly utilized option, autologous breast reconstruction, although technically more demanding, can also be successfully performed with appropriate modifications and microsurgical expertise, providing durable aesthetic and functional outcomes. This article reviews current reconstructive options with autologous breast reconstruction following robot-assisted mastectomy, discusses technical considerations unique to robotic approaches, and emphasizes the importance of individualized, patient-centered decision-making in reconstructive planning.