Recent advances and future directions in AI and robotics in plastic reconstructive breast surgery including 3D imaging

Abstract Autologous microsurgical breast reconstruction remains a cornerstone in complex reconstructive surgery. Since Holmström’s pioneering description of the first free TRAM flap, continuous advancements in diagnostic tools, such as 3D imaging and perforator mapping, have significantly enhanced surgical outcomes. This article also explores the integration of robotic surgery, initially developed for military and NASA applications, now widely adopted in minimally invasive procedures with systems like the Da Vinci robot. Emerging 3D imaging technologies, including AI-supported vascular anatomy visualizations, surface renderings, 3D-printed anatomical models, and cinematic vascular renderings, have contributed to intraoperative problem-solving. Additionally, the latest developments in preoperative, intraoperative, and postoperative applications of artificial intelligence are examined. In conclusion, this article highlights the growing role of AI in breast reconstruction and its future potential to revolutionize the field.