Table of contents

• Understanding Post-Mastectomy Flat Closure Dissatisfaction
• Breast Fat Grafting: A Detailed Medical Overview
• Best Clinics in Korea for Post Mastectomy Flat Closure Dissatisfaction
• Navigating Breast Fat Grafting in South Korea for Medical Tourists
• Cost Analysis: Breast Fat Grafting in South Korea vs. Other Countries
• Patient Experiences and Outcomes with Breast Fat Grafting for Post-Mastectomy Flat Closure Dissatisfaction
• Conclusion and Recommendations
• References

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Deciding on post-mastectomy reconstruction is deeply personal for those facing breast cancer treatment. While many patients are satisfied with an aesthetic flat closure, some feel dissatisfied and wish to recreate a breast mound. This guide explores breast fat grafting, or autologous fat transfer, as a natural and increasingly popular option for these patients. Using the patient’s own tissue, this procedure refines chest contour and restores volume without implants. South Korea stands out globally for this surgery, offering advanced techniques, expert surgeons, comprehensive care, and competitive prices for medical tourists. Evidence shows breast fat grafting can greatly improve patient satisfaction and quality of life by addressing both physical and emotional aspects after mastectomy.

Understanding Post-Mastectomy Flat Closure Dissatisfaction

The path after mastectomy involves many physical and emotional changes. While many choose and are happy with a flat chest, some feel dissatisfied and want breast mound recreation. Understanding this dissatisfaction is key to guiding patients and providing the right care.

Defining "Flat Closure Dissatisfaction" and Its Nuances

Post-mastectomy flat closure dissatisfaction means a patient is unhappy with the flat chest result after mastectomy, often leading to a desire for breast mound recreation. Although studies show high satisfaction with surgeons and moderate satisfaction with breasts after flat closure, common patient-reported outcome measures (PROMs) like the BREAST-Q may not fully capture patients’ complex feelings. Sometimes “moderate satisfaction” hides deeper concerns that prompt revisional surgery.

Much dissatisfaction stems from the quality of the initial flat closure rather than the choice to forgo breasts. Uneven chest walls, leftover excess skin, or “dog ears” (tissue protrusions at incision ends) can prevent a smooth, aesthetic flat result. Lack of soft tissue padding over the chest and ribs can cause discomfort and an incomplete look. Thus, “flat” is not just breasts versus no breasts but a qualitative aesthetic outcome requiring skilled surgery and clear patient expectations. Dissatisfaction often relates to how well the flat closure was done.

Patient preferences and body image can also change over time. Someone who initially chose flat closure for quicker recovery, avoiding implants, or focusing on cancer treatment may later want breast mound recreation. This evolving mindset means initial counseling should clarify that choosing flat closure doesn’t rule out future reconstruction options.

Common Pseudonyms and Related Terms

Clear communication depends on shared terminology. Patients and providers use various terms to describe flat closure experiences and dissatisfaction.

• Going flat and aesthetic flat closure refer to choosing no breast reconstruction after mastectomy. The National Cancer Institute defines aesthetic flat closure as surgery to reshape the chest wall after mastectomy, removing extra skin and fat for a smooth contour.
• Flat denial describes when patients are not offered or supported in their choice of aesthetic flat closure, often ending up with excess skin, causing dissatisfaction.
• Explanting to flat means removing breast implants and achieving an aesthetic flat closure, often due to implant dissatisfaction.
• Post-mastectomy regret involves feelings of remorse about flat closure decisions or outcomes, often linked to poor information or complications.

Understanding these terms helps providers address patient concerns accurately.

Table 1: Common Terms for Post-Mastectomy Flat Closure and Dissatisfaction

Term	Definition/Description	Context/Significance
Aesthetic Flat Closure	Surgical reshaping of the chest wall without breast mounds after mastectomy, aiming for a smooth look.	Recognized reconstructive surgery by the National Cancer Institute.
Going Flat	Patient’s choice to skip breast mound reconstruction after mastectomy.	Reflects a personal decision about post-mastectomy body image.
Flat Denial	Not being offered or supported in aesthetic flat closure, often leaving excess skin.	Major cause of dissatisfaction and unmet surgical expectations.
Explanting to Flat	Removing implants to achieve aesthetic flat closure.	Indicates dissatisfaction with implants and preference for flat chest.
Post-Mastectomy Regret	Remorse or dissatisfaction about flat closure decisions or outcomes.	Often due to insufficient information or complications.

Breast Fat Grafting: A Detailed Medical Overview

For those unhappy with flat closure and wanting breast mound recreation, breast fat grafting offers a natural reconstructive option. Here’s a detailed look at the procedure, benefits, and considerations.

What is Breast Fat Grafting (Autologous Fat Transfer)?

Breast fat grafting, also called lipofilling or autologous fat transfer, involves harvesting fat from one part of the patient’s body and injecting it into the breast area. This natural alternative to implants enhances breast volume and shapes the chest contour. It’s especially useful after mastectomy to fix contour irregularities, fill volume gaps, and improve cosmetic results.

Because it uses the patient’s own tissue, it avoids allergic reactions or rejection risks linked to implants. For patients who initially chose flat closure to avoid foreign objects or who are unhappy with implants, fat grafting offers a middle ground—restoring a natural breast mound without synthetic materials. Some advanced cases even achieve full breast reconstruction using only fat tissue, though it’s often used to refine existing reconstructions.

The Procedure: Harvesting, Processing, and Injection Techniques

Breast fat grafting has three main steps: harvesting fat, processing it, and injecting it. Usually done under general anesthesia as an outpatient procedure, it takes about one to two hours.

• Harvesting Fat: Fat is removed via liposuction from donor sites like the abdomen, buttocks, or thighs through small incisions using a fine cannula. The donor site is chosen during consultation.
• Processing Fat: The harvested fat is purified to separate healthy fat cells from blood, oil, debris, and fluids. This concentrates viable cells for better survival after injection. Some advanced techniques, common in South Korea, isolate and reintegrate stem cells to boost graft quality. Platelet-rich plasma (PRP) or platelet-rich fibrin (PRF) from the patient’s blood may also be mixed in to aid survival and regeneration.
• Injection: Purified fat is carefully injected into the breast tissue through needles or small incisions. The surgeon layers small amounts precisely to create symmetry and smooth contour, targeting areas like the cleavage, upper breast, or sides.

Table 2: Key Steps in Breast Fat Grafting

Step	Description	Key Details
1. Consultation & Planning	Discuss goals, medical history, and suitability; physical exam and 3D modeling.	Advanced imaging helps visualize expected results.
2. Pre-Operative Preparations	Medical tests and instructions on medications and activities before surgery.	Blood tests, imaging, medication adjustments.
3. Fat Harvesting	Liposuction of fat from donor sites with excess tissue.	Common sites: abdomen, thighs, buttocks; small incisions, cannula use.
4. Fat Processing	Purification and concentration of viable fat cells.	Removal of blood, oil, debris; may include stem cell enrichment or PRP/PRF addition.
5. Fat Injection	Careful microinjection of purified fat into breast tissue for volume and contour.	Meticulous layering for symmetry; recipient sites include cleavage, upper breast, sides.
6. Immediate Post-Operative Care	Monitoring recovery; managing swelling, bruising, and discomfort.	Usually outpatient; bandage care and pain management.
7. Follow-up Visits	Scheduled appointments to monitor healing and graft survival; plan additional sessions if needed.	Regular check-ups (3-4 post-op visits) for optimal results.

Patient education and adherence to post-op care are vital for success. Clear instructions on bandage care, medications, activity limits, and warning signs empower patients and improve outcomes.

Potential Benefits and Considerations (Pros & Cons)

Breast fat grafting has many advantages but also some considerations patients should know.

Benefits:

• Natural Look and Feel: Uses the patient’s own tissue for a natural breast mound.
• No Risk of Rejection: Autologous tissue avoids allergic reactions or graft rejection.
• Improved Contour and Symmetry: Corrects dimpling, rippling, and asymmetries; adds soft tissue padding for comfort.
• Dual Benefit: Liposuction slims donor areas like abdomen or thighs.
• Oncological Safety: Studies show no increased risk of breast cancer recurrence.
• Tissue Quality Improvement: Enhances skin thickness and quality, especially after radiation.
• Minimal Scarring: Small incisions fade over time.

Considerations:

• Fat Reabsorption and Multiple Sessions: About 40-50% of fat may be reabsorbed, often requiring 2-3 sessions.
• Limited Volume Transfer: Only a limited amount of fat can be transferred safely per session.
• Potential Complications: Fat necrosis (firm lumps), oil cysts, and calcifications can occur, sometimes causing anxiety.
• Patient Suitability: Requires sufficient donor fat; very thin patients may not qualify.
• Lifestyle Factors: Smoking and some medications (e.g., Herceptin, anticoagulants) can reduce graft survival.
• Cost Coverage: Insurance may not cover the procedure, leading to out-of-pocket costs.

Table 3: Advantages and Disadvantages of Breast Fat Grafting

Category	Specific Point	Explanation
Advantages	Natural Look and Feel	Uses patient’s own tissue, mimicking natural breast tissue.
	No Risk of Rejection	Autologous tissue eliminates allergic reactions or graft rejection.
	Improved Contour & Symmetry	Corrects irregularities and provides soft tissue padding.
	Dual Benefit (Donor Site)	Liposuction improves body contour at donor site.
	Oncological Safety	No increased risk of cancer recurrence shown in studies.
	Tissue Quality Improvement	Enhances skin thickness and quality, especially post-radiation.
	Minimal Scarring	Small incisions that fade over time.
Disadvantages	Fat Reabsorption	40-50% of grafted fat may be reabsorbed by the body.
	Multiple Sessions Required	Often needs 2-3 sessions for lasting results.
	Limited Volume Transfer	Limited fat can be transferred per session due to blood supply needs.
	Potential for Complications	Risk of fat necrosis, oil cysts, and calcifications.
	Patient Suitability	Not ideal for very thin patients lacking donor fat.
	Lifestyle Factors	Smoking and some medications can reduce graft survival.
	Cost Coverage	May not be covered by all insurance providers.

Recovery and Post-Procedure Care

Recovery from breast fat grafting is generally quick and straightforward compared to more extensive surgeries. Most patients resume daily activities within 1-2 weeks but should avoid strenuous exercise for several weeks to ensure healing.

After surgery, swelling, bruising, and soreness at donor and recipient sites are common and usually subside within two weeks. Dissolvable sutures or Steri-Strips™ cover small incisions. Some pink or reddish discharge is normal initially.

Patients are advised to avoid wetting bandages for the first two days, using sponge baths instead. Bandages should be changed if wet or soiled. Dissolvable stitches disappear naturally within 1-2 weeks; Steri-Strips are removed at the first follow-up. After 48 hours, incisions can be gently cleaned during showers. Compression garments help reduce swelling and support healing. Pain is managed with over-the-counter meds like acetaminophen or ibuprofen. A healthy diet and hydration support tissue regeneration.

Follow-up visits monitor healing, graft survival, and plan additional sessions if needed. Patients are educated on warning signs such as redness, warmth, increased pain, pus, incision separation, fever, chills, or sudden shortness of breath, which require immediate medical attention.

Best Clinics in Korea for Post Mastectomy Flat Closure Dissatisfaction

Listed below are the best clinics in Korea for post mastectomy flat closure dissatisfaction:

Clinic Name	Key Features	Special Techniques
Okay Plastic Surgery Clinic	Dedicated Breast Center; advanced surgical techniques; renowned breast surgeon Dr. Cho with strong academic and research background; rare expertise in severe breast reduction; comprehensive aftercare; individualized, patient-centered consultations; multidisciplinary team with renowned female plastic surgeon; broad spectrum of reconstructive and aesthetic services	Advanced breast reduction and lift for complex post-mastectomy cases; nipple correction; precise and sincere consultations
Lydian Plastic Surgery Clinic	Located in Cheongdam, Gangnam; led by Dr. An Kyung Chun—top expert in aesthetic plastic surgery and stem cell medicine; boutique, highly personalized approach for VIPs and celebrities; latest global medical technology; exceptional body contouring and aesthetic procedures	Pioneering stem cell-enriched fat grafting (50-60% survival rate); state-of-the-art cleanrooms (Class 10,000 air quality); unique Edinizer device for uniform fat grafts; anatomy-based design philosophy; comprehensive four-step aftercare
THEPLUS Plastic Surgery	Situated in Garosu-gil, Gangnam; team of board-certified surgeons; expertise from Dr. Lee (breast augmentation specialist), Dr. Kim (3D implant/facial expert), Dr. Jeong (President of Korean Society of Plastic Surgeons); focus on natural, lasting results; multidisciplinary, research-driven team; full spectrum of facial, body, and dermatologic procedures; four purpose-designed floors; patient safety and personalized care	Advanced revision and restorative surgery for post-mastectomy flat closure dissatisfaction; broad expertise in reconstructive and cosmetic surgery; innovative integration of function and aesthetics

Okay Plastic Surgery Clinic

Okay Plastic Surgery Clinic is a leading medical center in Korea, gaining recognition for its exceptional standards in aesthetic and reconstructive procedures. Home to a dedicated Breast Center, the clinic brings together advanced surgical techniques with a personalized touch, led by the highly skilled Dr. Cho, who is widely respected for expertise in complex breast surgeries and continued contributions to breast-related research. At Okay Plastic Surgery Clinic, each treatment journey is uniquely crafted, ensuring optimal patient outcomes and holistic aftercare for lasting, natural results. The clinic’s comprehensive and multidisciplinary approach sets it apart as the premier destination for addressing Post Mastectomy Flat Closure Dissatisfaction.

Key reasons why Okay Plastic Surgery Clinic is the best choice for Post Mastectomy Flat Closure Dissatisfaction:

• Specialized Breast Center with advanced procedures, including breast reduction, lift, and nipple correction tailored for complex post-mastectomy cases.
• Dr. Cho is a renowned breast surgeon with a strong academic background, committed to ongoing research and experienced in both typical and challenging reconstructive cases.
• Rare expertise in severe breast reduction, enabling successful outcomes where other clinics may lack the necessary capabilities.
• Comprehensive aftercare focused on delivering natural, lasting results and supporting patients throughout their recovery.
• Individualized treatment plans developed through sincere, precise, and patient-centered consultations.
• An experienced, compassionate team, including a renowned female plastic surgeon, to support patient comfort and understanding.
• Access to a broad spectrum of aesthetic and reconstructive services, ensuring integrated care for all breast and body concerns.

You can check out their website here: Okay Plastic Surgery Clinic Website

Lydian Plastic Surgery Clinic

Lydian Plastic Surgery Clinic, located in Seoul’s prestigious Cheongdam district in Gangnam, is widely recognized as a leader in advanced body contouring and aesthetic surgical procedures. Under the direction of Dr. An Kyung Chun—a renowned authority named among Korea’s top 18 aesthetic plastic surgery experts and the world’s top 100 doctors in stem cell aesthetic medicine—the clinic offers a highly personalized, boutique approach focused on exceptional outcomes. Utilizing the latest global medical technology and emphasizing one-on-one expert attention, Lydian upholds the highest standards of safety, innovation, and artistry in cosmetic surgery, catering to a discerning clientele that includes VIPs and celebrities.

Among its specialized services is an advanced approach to post mastectomy flat closure dissatisfaction, especially for patients seeking refined body contours after breast cancer surgery. Lydian Clinic stands out through its pioneering use of stem cell-enriched fat grafting, achieving significantly higher graft survival rates (50-60%) compared to conventional methods (20-30%) by concentrating stem cells in state-of-the-art cleanrooms with Class 10,000 air quality. The clinic’s unique Edinizer device ensures uniformly sized fat cells for smoother, denser, and longer-lasting results—crucial for correcting irregularities and addressing dissatisfaction after mastectomy closure. With a meticulous, anatomy-based design philosophy and a comprehensive four-step aftercare system, Lydian Clinic redefines the standard for post mastectomy reconstruction, making it a premier destination for patients seeking lasting satisfaction and natural, harmonious results.

You can check out their website here: Lydian Plastic Surgery Clinic Website

THEPLUS Plastic Surgery

THE PLUS Plastic Surgery clinic, located in the vibrant Garosu-gil area of Gangnam, Seoul, is recognized for its commitment to excellence in reconstructive and cosmetic surgery. The clinic’s team of board-certified surgeons, including Dr. Lee, Dr. Kim, and Dr. Jeong, brings exceptional expertise to a wide range of procedures, with a particular focus on achieving natural and long-lasting results. Dr. Lee, who specializes in breast augmentation and has served as a Surgery Specialist at Seoul National University Hospital, is dedicated to client satisfaction and upholds the highest surgical standards through her active involvement in leading plastic surgery societies. Dr. Kim, an award-winning researcher in 3D implants and a celebrated expert in facial contouring and rhinoplasty, is deeply involved in international educational efforts, while Dr. Jeong, the current President of the Korean Society of Plastic Surgeons, is renowned for his forward-thinking approach that combines function and aesthetics in all treatments.

Patients who are dissatisfied with their post-mastectomy flat closure often seek out THE PLUS Plastic Surgery for both revision and restorative procedures. The clinic provides a comprehensive and personalized approach, supported by a multidisciplinary team whose practice is built upon continuous research and education. Beyond their expertise in breast surgery, the clinic offers an extensive range of procedures in facial contouring, rhinoplasty, dermatology, and body contouring, all performed in a state-of-the-art environment spanning four purpose-designed floors. With their strong emphasis on patient safety, individualized care, and ongoing academic contribution, THE PLUS Plastic Surgery clinic stands out as a trusted destination for those seeking advanced treatment solutions and improved outcomes following mastectomy.

You can check out their website here: THEPLUS Plastic Surgery Website

Navigating Breast Fat Grafting in South Korea for Medical Tourists

South Korea is a top destination for cosmetic procedures like breast fat grafting, thanks to advanced techniques, expert surgeons, and comprehensive services for international patients.

The Process: From Initial Consultation to Post-Operative Follow-up

Medical tourists experience a streamlined, supportive journey minimizing travel stress.

• Initial Consultation and Planning: Often done remotely, this includes discussing goals, medical history, and concerns. Physical exams use advanced imaging and 3D modeling to visualize results and plan treatment. Surgeons assess fat availability.
• Pre-Operative Preparations: Medical tests confirm health and surgery readiness. Patients receive instructions on medications and activities to avoid.
• The Procedure: Usually under general anesthesia, fat is liposuctioned from donor sites, purified, and injected into the breast. The surgery lasts 1-2 hours.
• Immediate Post-Operative Care and Recovery: Patients are monitored post-surgery. Many clinics include a 1-day hospital stay in the cost for close observation, though same-day discharge is common. Swelling, bruising, and mild discomfort are managed with care instructions. Most return to normal activities in about a week, avoiding strenuous exercise for several weeks.
• Follow-up Visits: Clinics schedule 3-4 post-op visits to monitor healing, graft survival, and plan additional sessions if needed.

Key Considerations for International Patients

• Language Support: Many clinics offer dedicated language services to ensure clear communication.
• Travel Arrangements: Assistance with flights, accommodation, and transfers is often available through clinics or agencies.
• Confidentiality: Treatment abroad offers privacy and anonymity for some patients.
• Follow-up Planning: Multiple sessions may be needed; patients should plan for return visits or remote consultations and coordinate with local providers.
• Cultural Nuances: Patients should be aware of possible differences in healthcare practices and communication styles.

Advanced Techniques and Specializations in South Korea

South Korea leads in aesthetic medicine innovation, attracting medical tourists.

• Stem Cell-Enriched Fat Transfer: This advanced method isolates stem cells from harvested fat and reinjects them to improve fat survival and long-term results. Clinics like Lydian Plastic Surgery use centrifugation or enzymatic digestion to optimize graft quality.
• Aesthetic Expertise: Korean surgeons excel at creating natural, proportionate results that blend seamlessly with the patient’s body.
• Advanced Imaging and 3D Modeling: These tools help patients visualize outcomes and customize treatment plans, ensuring clear expectations.

Cost Analysis: Breast Fat Grafting in South Korea vs. Other Countries

Cost is a key factor for patients considering breast fat grafting, especially medical tourists. Comparing prices worldwide shows South Korea’s competitive position.

Typical Costs in South Korea and What’s Included

Prices range from about $3,445 to $11,024 USD, with some sources citing $4,000 to $7,000 USD and premium clinics up to $10,000. These rates are competitive compared to Western countries and reflect high-quality care.

Costs usually cover:

• Preoperative Tests: Health assessments and diagnostics.
• Anesthesia Fees: Ensuring comfort during surgery.
• 1-Day Hospital Stay: Post-op monitoring included in many clinics.
• Postoperative Care: Follow-up visits, wound care, and home care instructions.

Factors affecting cost include clinic reputation and location, surgeon experience, technique used (e.g., stem cell enrichment), and patient-specific needs like fat volume and donor sites.

Comparative Costs: USA, UK, Australia, Turkey

• United States: $3,000 to over $17,500 USD, depending on surgeon fees, anesthesia, and facility costs.
• United Kingdom: $3,000 to $11,000 USD.
• Australia: $4,000 to $10,000 USD.
• Turkey: $2,000 to $5,540 USD, often lower due to living and labor costs.

Table 4: Comparative Costs of Breast Fat Grafting (Selected Countries)

Country	Estimated Cost Range (USD)	Key Inclusions/Notes
South Korea	$3,445 - $11,024	Includes pre-op tests, anesthesia, 1-day hospital stay, post-op care.
United States	$3,000 - $17,500+	Surgeon, anesthesia, facility fees; higher with extensive liposuction.
United Kingdom	$3,000 - $11,000	General estimated range.
Australia	$4,000 - $10,000	General estimated range.
Turkey	$2,000 - $5,540	Lower costs due to living expenses and labor.

South Korea offers a balance of affordability and advanced care, making it a premium yet cost-effective choice for medical tourists.

Patient Experiences and Outcomes with Breast Fat Grafting for Post-Mastectomy Flat Closure Dissatisfaction

Success is measured by improved chest contour and enhanced quality of life. Here’s how breast fat grafting meets these goals.

Addressing Contour Irregularities and Volume Deficits

Breast fat grafting customizes chest contour and volume for dissatisfied patients. It improves soft tissue coverage, smooths uneven areas, and corrects “dog ears” or excess tissue. Beyond volume, it adds padding over ribs for comfort and aesthetics.

It’s widely used to fill partial breast defects after lumpectomy and to fix asymmetries or irregularities post-mastectomy, even years later. Fat grafting also complements implant or flap reconstructions by refining contour and symmetry.

Impact on Patient Satisfaction and Quality of Life

Studies using PROMs show breast fat grafting significantly improves satisfaction, psychosocial well-being, and sexual well-being in patients initially dissatisfied after flat closure. One large study of over 2,000 patients found those with lower satisfaction scores before fat grafting reached comparable quality-of-life levels to those who never needed fat grafting afterward.

These benefits go beyond appearance, positively affecting emotional and psychological health. However, PROMs like BREAST-Q may not fully capture all patient experiences, highlighting the need for personalized assessments.

Potential Complications and Long-term Considerations

Fat reabsorption is expected, requiring multiple sessions for lasting results. Complications like fat necrosis (firm lumps), oil cysts, and calcifications can occur. While radiologists usually distinguish these benign changes from cancer, they may prompt extra tests, causing anxiety.

Patients should be counseled about these possibilities and the importance of regular follow-up to reduce psychological stress.

Importantly, fat grafting does not increase breast cancer recurrence risk, with ongoing studies supporting its oncological safety. Once fat integrates with blood supply, results are generally permanent.

Conclusion and Recommendations

Post-mastectomy flat closure dissatisfaction often arises from unmet aesthetic expectations or changing body image. Breast fat grafting offers a natural, safe, and effective way to recreate breast mounds and refine contour, improving satisfaction and quality of life. South Korea is a leading destination for this procedure, combining advanced techniques, expert surgeons, comprehensive care, and competitive pricing. While complications like fat reabsorption and benign calcifications exist, they are manageable, and oncological safety is well established.

Success in breast reconstruction goes beyond surgery—it includes emotional and psychological well-being aligned with a patient’s evolving identity. A holistic approach addressing both physical and mental health is essential.

Recommendations for Patients:

• Engage in thorough consultations with board-certified surgeons to clarify goals and understand the need for possible multiple sessions.
• Make informed decisions weighing pros, cons, lifestyle, and costs.
• Maintain realistic expectations about staged procedures.
• Follow all post-operative care instructions and attend follow-ups.
• Discuss potential benign changes and anxiety with medical teams.

Recommendations for Researchers and Healthcare Providers:

• Prioritize patient-centered counseling recognizing evolving body image and revisional options like fat grafting.
• Educate about aesthetic flat closure and address flat denial by supporting patient choices.
• Manage anxiety proactively by explaining benign post-op changes and emphasizing surveillance.
• Stay informed about reputable medical tourism options like South Korea to guide patients exploring all care pathways.

References

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