The Flap Revolution: New Workhorses, Smarter Breast Reconstruction & AI in Your OR

Are SCIP, SIEA, and PAP flaps about to replace your go-to reconstructive options? Should you be doing pre-pectoral implants over sub-pectoral? And is AI actually useful in your OR — or just another tech buzzword?In this episode we break down five fresh 2025 papers covering the biggest shifts in flap selection, breast reconstruction, and surgical technology. We cover the emerging SCIP/SIEA/PAP flaps and why they're being called the new workhorses for soft tissue reconstruction across all body regions, the latest on robotic-assisted LD flap and pre-pectoral reconstruction, and a concept most surgeons never learned in residency — flap autonomization, and why understanding its timeline actually matters for your postoperative decisions. We also cut through the AI hype with a 15-year systematic review on what machine learning can and can't do in plastic surgery, and wrap with a surprising RCT showing 3D telemedicine genuinely outperforms 2D for reconstructive follow-up.Essential listening for anyone who operates with flaps or is curious about where the specialty is heading.