Aesthetic-oriented breast reconstruction: a feasibility study of a novel technique combining Suture-Based Marking Scar Minimising and Axillary-Lateral Thoracic Fat Flap Reconstruction with Tissue Sliding (S-SMARTS)

Khoo, Hui Ying; Sota, Yoshiaki; Shimazu, Kenzo

doi:https://doi.org/10.1007/s00595-026-03285-1

Aesthetic-oriented breast reconstruction: a feasibility study of a novel technique combining Suture-Based Marking Scar Minimising and Axillary-Lateral Thoracic Fat Flap Reconstruction with Tissue Sliding (S-SMARTS)

Khoo, Hui Ying; Sota, Yoshiaki; Shimazu, Kenzo

Surgery Today, 2026

アクセス数:127件（2026-08-24 19:04 集計）

固定URL: https://hdl.handle.net/11094/105104

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タイトル	Aesthetic-oriented breast reconstruction: a feasibility study of a novel technique combining Suture-Based Marking Scar Minimising and Axillary-Lateral Thoracic Fat Flap Reconstruction with Tissue Sliding (S-SMARTS)
著者	NRID 1000070591022 1000070591022 ORCID 0000-0002-4039-0520 0000-0002-4039-0520 researchmap permalink hmkhoo hmkhoo Scopus Author ID 55314143200 55314143200 著者名 Khoo, Hui Ying
	NRID 1000080943779 1000080943779 ORCID 0000-0001-5963-652X 0000-0001-5963-652X researchmap permalink y_sota123 y_sota123 Scopus Author ID 56308090600 56308090600 著者名 Sota, Yoshiaki
	NRID 1000030448039 1000030448039 ORCID 0000-0002-0837-2357 0000-0002-0837-2357 researchmap permalink _-23f _-23f Scopus Author ID 7005224756 7005224756 著者名 Shimazu, Kenzo
キーワード等	Hidden scar breast surgery
	Breast-conserving surgery
	S-SMARTS technique
内容	Khoo Hui Ying, Sota Yoshiaki, Shimazu Kenzo. Aesthetic-oriented breast reconstruction: a feasibility study of a novel technique combining Suture-Based Marking Scar Minimising and Axillary-Lateral Thoracic Fat Flap Reconstruction with Tissue Sliding (S-SMARTS). Surgery Today (2026); https://doi.org/10.1007/s00595-026-03285-1.
抄録	Breast-conserving surgery with radiotherapy offers outcomes comparable to those of mastectomy. However, margin control and cosmetic results remain challenging, especially for deep or unfavorably located tumors. This study evaluated the S-SMARTS technique (suture-based marking, scar minimizing, and axillary-lateral thoracic fat flap reconstruction with tissue sliding), a hidden-scar, volume displacement method using axillary and lateral thoracic fat flaps. In this single-center retrospective study (Osaka University, Jan 2020–Apr 2025), 44 patients underwent breast-conserving surgery using S-SMARTS. The margin status and cosmetic outcomes (via BCCT.core) were analyzed. Negative margins were achieved in 95.5% of cases on the initial excision and 100% after intraoperative frozen section. The BCCT.core assessment demonstrated that 76.2% of the cases had “Good/Excellent” and 23.8% had “Fair” outcomes. Multivariate analyses were performed to explore any potential predictors of margin positivity. However, no statistically robust predictors were identified. S-SMARTS demonstrates technical feasibility and acceptable early oncologic and aesthetic outcomes in a single-surgeon cohort. Further comparative and multi-institutional studies are warranted to validate its oncologic impact, reproducibility, and patient-reported aesthetic benefits.
出版者	Springer Science and Business Media LLC
収録物名	Surgery Today
刊行年月	2026-05-23
言語	英語
ハンドルURL	https://hdl.handle.net/11094/105104
PISSN	09411291
eISSN	14362813
関連情報 (isIdenticalTo)	DOI (出版社版) https://doi.org/10.1007/s00595-026-03285-1
アクセス権	open access
権利情報	This article is licensed under a Creative Commons Attribution 4.0 International License.
出版タイプ	Version of Record
カテゴリ	学術雑誌論文 Journal Article

資源タイプ	学術雑誌論文
ローカル資源タイプ	学術雑誌論文
DCMI資源タイプ	text
DCTERMS.bibliographicCitation	Surgery Today. 2026
DC.title	Aesthetic-oriented breast reconstruction: a feasibility study of a novel technique combining Suture-Based Marking Scar Minimising and Axillary-Lateral Thoracic Fat Flap Reconstruction with Tissue Sliding (S-SMARTS)
DC.creator	Khoo, Hui Ying
	Sota, Yoshiaki
	Shimazu, Kenzo
DC.publisher	Springer Science and Business Media LLC
DC.language' scheme='DCTERMS.RFC1766	英語
DC.type' scheme='DCTERMS.DCMIType	text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2026-05-23
DC.identifier	https://doi.org/10.1007/s00595-026-03285-1
DC.subject	Hidden scar breast surgery
	Breast-conserving surgery
	S-SMARTS technique
DC.description	Khoo Hui Ying, Sota Yoshiaki, Shimazu Kenzo. Aesthetic-oriented breast reconstruction: a feasibility study of a novel technique combining Suture-Based Marking Scar Minimising and Axillary-Lateral Thoracic Fat Flap Reconstruction with Tissue Sliding (S-SMARTS). Surgery Today (2026); https://doi.org/10.1007/s00595-026-03285-1.
DCTERMS.abstract	Breast-conserving surgery with radiotherapy offers outcomes comparable to those of mastectomy. However, margin control and cosmetic results remain challenging, especially for deep or unfavorably located tumors. This study evaluated the S-SMARTS technique (suture-based marking, scar minimizing, and axillary-lateral thoracic fat flap reconstruction with tissue sliding), a hidden-scar, volume displacement method using axillary and lateral thoracic fat flaps. In this single-center retrospective study (Osaka University, Jan 2020–Apr 2025), 44 patients underwent breast-conserving surgery using S-SMARTS. The margin status and cosmetic outcomes (via BCCT.core) were analyzed. Negative margins were achieved in 95.5% of cases on the initial excision and 100% after intraoperative frozen section. The BCCT.core assessment demonstrated that 76.2% of the cases had “Good/Excellent” and 23.8% had “Fair” outcomes. Multivariate analyses were performed to explore any potential predictors of margin positivity. However, no statistically robust predictors were identified. S-SMARTS demonstrates technical feasibility and acceptable early oncologic and aesthetic outcomes in a single-surgeon cohort. Further comparative and multi-institutional studies are warranted to validate its oncologic impact, reproducibility, and patient-reported aesthetic benefits.
DC.rights	This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	105104
citation_title	Aesthetic-oriented breast reconstruction: a feasibility study of a novel technique combining Suture-Based Marking Scar Minimising and Axillary-Lateral Thoracic Fat Flap Reconstruction with Tissue Sliding (S-SMARTS)
citation_author	Khoo, Hui Ying
	Sota, Yoshiaki
	Shimazu, Kenzo
citation_publisher	Springer Science and Business Media LLC
citation_language	英語
citation_date	2026-05-23
citation_journal_title	Surgery Today
citation_doi	https://doi.org/10.1007/s00595-026-03285-1
citation_public_url	https://hdl.handle.net/11094/105104

Aesthetic-oriented breast reconstruction: a feasibility study of a novel technique combining Suture-Based Marking Scar Minimising and Axillary-Lateral Thoracic Fat Flap Reconstruction with Tissue Sliding (S-SMARTS)

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