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

Number of Access:127（2026-08-24 20:10 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/105104

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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)
Creator
NRID
1000070591022 1000070591022
ORCID
0000-0002-4039-0520 0000-0002-4039-0520
researchmap permalink
hmkhoo hmkhoo
Scopus Author ID
55314143200 55314143200
CreatorName
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
CreatorName
Sota, Yoshiaki
NRID
1000030448039 1000030448039
ORCID
0000-0002-0837-2357 0000-0002-0837-2357
researchmap permalink
_-23f _-23f
Scopus Author ID
7005224756 7005224756
CreatorName
Shimazu, Kenzo
Subject
Hidden scar breast surgery
Breast-conserving surgery
S-SMARTS technique
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.
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.
Publisher
Springer Science and Business Media LLC
Source Title
Surgery Today
Date of Issued
2026-05-23
Language
English
Handle URL
https://hdl.handle.net/11094/105104
PISSN
09411291
eISSN
14362813
Relation.isIdenticalTo
DOI (Publisher Version)
https://doi.org/10.1007/s00595-026-03285-1
Access Rights
open access
CopyRight
This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version
Version of Record
Category
学術雑誌論文 Journal Article