Superficial Thinning of the DIEP Flap: A Safe Option to Achieve an Aesthetic Reconstructed Breast in the Obese Patient

Miguel De la Parra-Marquez; Ricardo Fernandez-Riera; Elizabeth Romay-Chambers; Tomas Escamilla Linaje

doi:10.1097/prs.0000000000008481

Superficial Thinning of the DIEP Flap: A Safe Option to Achieve an Aesthetic Reconstructed Breast in the Obese Patient

Plastic & Reconstructive Surgery ◽

10.1097/prs.0000000000008481 ◽

2021 ◽

Vol 148 (5) ◽

pp. 715e-719e

Author(s):

Miguel De la Parra-Marquez ◽

Ricardo Fernandez-Riera ◽

Elizabeth Romay-Chambers ◽

Tomas Escamilla Linaje

Keyword(s):

Obese Patient ◽

Diep Flap ◽

Safe Option ◽

Reconstructed Breast

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Aesthetical outcome after breast reconstruction using deep inferior epigastric perforator flap: Personal techniques

Indian Journal of Plastic Surgery ◽

10.4103/0970-0358.121997 ◽

2013 ◽

Vol 46 (03) ◽

pp. 513-517 ◽

Cited By ~ 1

Author(s):

Chiara Gelati ◽

Luca Negosanti ◽

Erich Fabbri ◽

Riccardo Cipriani

Keyword(s):

Breast Reconstruction ◽

Perforator Flap ◽

Diep Flap ◽

Breast Asymmetry ◽

Inferior Pole ◽

The World ◽

Deep Inferior Epigastric Perforator ◽

Reconstructed Breast

ABSTRACT Background: Now-a-days, deep inferior epigastric perforator (DIEP) flap breast reconstruction is widespread throughout the world. The aesthetical result is very important in breast reconstruction and its improvement is mandatory for plastic surgeons. Materials and Methods: The most frequent problems, we have observed in breast reconstruction with DIEP flap are breast asymmetry in terms of volume and shape, the bulkiness of the inferior lateral quadrant of the new breast, the loss of volume of the upper pole and the lack of projection of the inferior pole. We proposed our personal techniques to improve the aesthetical result in DIEP flap breast reconstruction. Our experience consists of more than 220 DIEP flap breast reconstructions. Results: The methods mentioned for improving the aesthetics of the reconstructed breast reported good results in all cases. Conclusion: The aim of our work is to describe our personal techniques in order to correct the mentioned problems and improve the final aesthetical outcome in DIEP flap breast reconstruction.

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EP.TH.286Optimisation of Secondary Breast Reconstruction

British Journal of Surgery ◽

10.1093/bjs/znab309.036 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Klemen Lovšin ◽

Uroš Ahčan ◽

Andrej Lapoša

Keyword(s):

Patient Satisfaction ◽

Breast Reconstruction ◽

Free Flap ◽

Intercostal Nerve ◽

Diep Flap ◽

Autologous Breast Reconstruction ◽

Patient Satisfaction Score ◽

Preliminary Results ◽

Level Of Satisfaction ◽

Reconstructed Breast

Abstract Aims The purpose of secondary breast reconstruction is to restore patient’s integrity. Autologous breast reconstruction has become the superior method of breast reconstruction, especially in cases with inadequate skin envelope and post-radiotherapy tissue damage. A 3D-template-enhanced secondary autologous breast reconstruction with restoration of innervation was developed at our department. Methods Thirty patients are planned to be included in the prospective double-blinded study. The reconstruction is performed with the deep inferior epigastric perforator (DIEP) free flap using 3D template from the contralateral healthy breast. Additionally, coaptation of the anterior branch of the 3rd intercostal nerve with the dominant lateral intercostal nerve innervating the DIEP flap is performed. Breast-Q questionnaires are collected before and after the reconstruction and the breast sensation is assessed on regular intervals. Results The preliminary results show an improvement in the sensation of the reconstructed breast and higher patient satisfaction score. Prior to abstract submission, no significant complications have been noted, in one patent abnormal sensation of the breast was reported. Conclusions According to previous studies, patients with innervated free flap reconstruction express higher level of satisfaction as the sensation of the reconstructed breast contributes significantly to the level of satisfaction. Furthermore, use of 3D model from the contralateral breast produces results that are superior to traditional methods. Preliminary results showed that the combination of both methods improved patient satisfaction regarding the aesthetic outcome and functional result. With the appropriate patient selection this type of optimised breast reconstruction should be performed.

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