scholarly journals 4: Four-flap Breast Reconstruction: Assessing Breast-q And Donor Site Morbidity In Bilateral Stacked Autologous Breast Reconstruction

2021 ◽  
Vol 9 (7S) ◽  
pp. 41-41
Author(s):  
Ryan M. Dickey ◽  
Ricardo Garza ◽  
Yulun Liu ◽  
Min Jeong Cho ◽  
Sumeet S. Teotia ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Autologous Breast Reconstruction

scholarly journals The transverse musculocutaneous gracilis flap for autologous breast reconstruction: focus on donor site morbidity

Breast Cancer ◽  
2021 ◽  
Author(s):  
Laura C. Siegwart ◽  
Sebastian Fischer ◽  
Yannick F. Diehm ◽  
Jörg M. Heil ◽  
Christoph Hirche ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Donor Site ◽  
Wound Dehiscence ◽  
Donor Site Morbidity ◽  
Normal Weight ◽  
Autologous Breast Reconstruction ◽  
Medial Thigh ◽  
The Mean ◽  
Breast Shape ◽  
Surgical Site Complications

Abstract Purpose The transverse musculocutaneous gracilis (TMG) flap is as a valuable alternative in autologous breast reconstruction. The purpose of this study was to evaluate the donor site morbidity and secondary refinement procedures after TMG flap breast reconstruction. Methods A retrospective study was conducted, including all patients who received TMG flap breast reconstructions, from January 2012 to August 2019. Primary outcomes were surgical site complications of the donor site and secondary refinement procedures carried out for aesthetic or reconstructive purposes for the medial thigh. Secondary outcomes of interest were lipofilling procedures for optimization of the reconstructed breasts. Results Ninety-nine patients received 159 TMG flaps for breast reconstruction. Patients’ mean BMI was 23.5 (15.6–32.5) kg/m2. Bilateral breast reconstructions were performed in 60.6%. The mean flap volume was 330 (231–440) g. Surgical site complications occurred in 14.5% of the TMG donor sites and wound dehiscence was the most common complication (9.4%). Lymphedema occurred in 1.8% of the donor thighs. Aesthetic refinement procedures were performed in 25.2% on the donor thigh or contralateral thigh. Secondary lipofilling was performed in 54.1% of the reconstructed breasts and fat was harvested in only 11.9% from the legs. Conclusion The TMG flap breast reconstruction combines low donor site morbidity with adequate volume for appealing breast results, particularly in slim-to-normal weight patients. However, patients should be informed about the likelihood of secondary refinement procedures on the donor site and the need of lipofilling to optimize the breast shape and volume.

Donor-Site Morbidity of the Transverse Musculocutaneous Gracilis Flap in Autologous Breast Reconstruction

2011 ◽  
Vol 128 (4) ◽  
pp. 233e-242e ◽  
Author(s):  
Petra Pülzl ◽  
Thomas Schoeller ◽  
Kristin Kleewein ◽  
Gottfried Wechselberger
Keyword(s):  
Breast Reconstruction ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Autologous Breast Reconstruction

scholarly journals The extended latissimus dorsi flap option in autologous breast reconstruction: A report of 14 cases and review of the literature

2008 ◽  
Vol 41 (01) ◽  
pp. 24-33
Author(s):  
Mohammed A. Rifaat ◽  
Ayman A. Amin ◽  
Mahmoud A Bassiouny ◽  
Ayman Nabawi ◽  
Sherif Monib
Keyword(s):  
Breast Reconstruction ◽  
Latissimus Dorsi ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Latissimus Dorsi Flap ◽  
Site Preference ◽  
Review Of The Literature ◽  
Autologous Breast Reconstruction ◽  
Wound Breakdown ◽  
Aesthetic Results

ABSTRACT Background: Autologous breast reconstruction using the extended latissimus dorsi flap has been infrequently reported. in the current study, the authors are reporting their own clinical experience with this method. a review of the literature is also discussed.Materials and methods: Over a three year period, 14 patients underwent breast reconstruction using the extended latissimus dorsi (ld) flap. patients with small to medium sized breasts were selected. the age of the patients ranged from 29 to 42 years with a follow-up period ranging from six to 18 months. the indications, flap-related complications and donor site morbidity and aesthetic results were evaluated.Results: The main indication to use the flap was dorsal donor site preference by patients. the remaining patients were either not suitable for a flap from the abdomen or wished to get pregnant and were offered the dorsal donor site. neither total nor partial flap loss was recorded but donor site morbidity was mainly due to seroma, which was treated conservatively in all patients, except for one who required surgery. another two patients suffered from wound breakdown and distal necrosis of the back flaps. mild contour deformity was also noted on the back of all patients but caused no major concern. indeed, the overall patient satisfaction was very high.Conclusion: The extended ld flap proved to be a good option for autologous breast reconstruction in selected patients. patients should be warned of the potential for seroma and mild contour back deformity.

scholarly journals Autologous Unilateral Breast Reconstruction with Venous Supercharged IMAP-Flaps: A Step by Step Guide of the Split Breast Technique

2020 ◽  
Vol 9 (9) ◽  
pp. 3030
Author(s):  
Kathrin Bachleitner ◽  
Laurenz Weitgasser ◽  
Amro Amr ◽  
Thomas Schoeller
Keyword(s):  
Breast Cancer ◽  
Surgical Technique ◽  
Breast Reconstruction ◽  
Donor Site ◽  
Operating Time ◽  
Cancer Recurrence ◽  
Free Tissue Transfer ◽  
Donor Site Morbidity ◽  
Aesthetic Result ◽  
Secondary Operations

Various techniques for breast reconstruction ranging from reconstruction with implants to free tissue transfer, with the disadvantage of either carrying a foreign body or dealing with donor site morbidity, have been described. In patients who had a unilateral mastectomy and offer a contralateral mamma hypertrophy a breast reconstruction can be performed with the excess tissue from the hypertrophic side using the split breast technique. Here a local internal mammary artery perforator (IMAP) flap of the hypertrophic breast can be used for reconstruction avoiding the downsides of implants or a microsurgical reconstruction and simultaneously reducing the enlarged donor breast in order to achieve symmetry. Methods: Between April 2010 and February 2019 the split breast technique was performed in five patients after mastectomy due to breast cancer. Operating time, length of stay, complications and the need for secondary operations were analyzed and the surgical technique including flap supercharging were described in detail. Results: All five IMAP-flaps survived and an aesthetically pleasant result could be achieved using the split breast technique. An average of two secondary corrections to achieve better symmetry were necessary after each breast reconstruction. Complications included venous flap congestion, partial flap necrosis and asymmetry. No breast cancer recurrence was recorded. An overall approval of the surgical technique among patients was observed. Conclusions: The use of the contralateral breast for unilateral total breast reconstruction represents an additional highly useful technique for selected patients, is safe and reliable results can be achieved. Although this technique is carried out as a single-stage procedure, including breast reduction and reconstruction at the same time, secondary operations may be necessary to achieve superior symmetry and a satisfying aesthetic result. Survival of the IMAP-flaps can be improved by venous supercharging of the flaps onto the thoracoepigastric vein.

Comprehensive Analysis of Donor-Site Morbidity in Abdominally Based Free Flap Breast Reconstruction

2013 ◽  
Vol 132 (6) ◽  
pp. 1383-1391 ◽  
Author(s):  
Edward I. Chang ◽  
Eric I. Chang ◽  
Miguel A. Soto-Miranda ◽  
Hong Zhang ◽  
Naveed Nosrati ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Free Flap ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Comprehensive Analysis

scholarly journals Refractory Donor-Site Seroma Following DIEP Breast Reconstruction

2020 ◽  
Vol 6 ◽  
pp. 2513826X1989883
Author(s):  
Trina V. Stephens ◽  
Nancy Van Laeken ◽  
Sheina A. Macadam
Keyword(s):  
Literature Review ◽  
Breast Reconstruction ◽  
Donor Site ◽  
Diep Flap ◽  
First Line ◽  
Percutaneous Aspiration ◽  
Autologous Breast Reconstruction ◽  
History Of ◽  
Deep Inferior Epigastric Perforator ◽  
Latissimus Dorsi Flaps

Donor-site seroma formation is a complication of autologous breast reconstruction reported most commonly with the use of latissimus dorsi flaps. First-line treatment is percutaneous aspiration which leads to resolution in the majority of cases. Those that persist may progress to a chronic, refractory seroma, which can prove challenging in terms of treatment. The aim of this article is to provide an updated literature review of interventions for chronic donor-site seroma and present the case of a 65-year-old female with a recalcitrant abdominal seroma following deep inferior epigastric perforator (DIEP) flap breast reconstruction. Literature review revealed a single article that reported 2 cases of persistent donor-site seroma after DIEP flap breast reconstruction. The patient presented here underwent repeat aspiration, drain placement, and multiple surgical procedures to achieve resolution. In total, the post-reconstruction seroma history of the patient extended over approximately 14 months. We conclude with evidence-based suggestions for chronic, donor-site seroma prevention and treatment.

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