We read with interest the article by Diep and colleagues on the learning curve for the use of indocyanine green angiography (ICGA) in post mastectomy breast reconstruction to improve outcomes1. This is an important finding on the surgeons’ experience required for effective use of the ICGA technique. As stated, clinical judgement remains the current standard at the time of tissue expander placement. However, it is a subjective assessment and varies between surgeons worldwide, partly due to differences in surgeons’ personal experience and surgical training.
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