Where should breast reconstruction evolve to address disparities, clinical challenges and technological advancements?

Abstract Breast reconstruction (BR) following mastectomy is a critical component of breast cancer management that aims to restore the physical appearance and improve the quality of life. Despite its benefits, BR utilization varies widely owing to patient and systemic factors. Advances in surgical techniques and technological innovations further shape the practice patterns. This review synthesizes recent evidence on BR decision‐making, clinical and psychosocial outcomes and emerging innovations, focusing on high‐risk populations. This review was conducted to evaluate the factors influencing BR decisions and clinical outcomes, including surgical risk, chronic pain, sensory changes and psychosocial outcomes after reconstruction. A search was performed using the PubMed and Cochrane Library databases and was limited to studies published in 2023 or later to ensure inclusion of the latest developments. Special attention was given to high‐risk groups and innovations such as robotics and machine learning. Patient demographics, insurance status and geographic disparities significantly impact the BR rates and methods. Clinical outcomes differ depending on surgical techniques and adjunct treatments, while psychosocial benefits include enhanced mental, physical and sexual well‐being. High‐risk populations experience higher complication rates, emphasizing the need for tailored counseling and risk management strategies. Emerging technologies, such as robot‐assisted procedures and predictive machine learning models, show promise for improving surgical precision and postoperative care. An individualized multidisciplinary approach to BR that addresses both clinical and psychosocial needs is essential. Integrating innovative technologies and implementing targeted risk management strategies can optimize outcomes and enhance the quality of life of diverse patient populations.