Bilateral Breast Revision Augmentation With Deep Inferior Epigastric Perforators/Superficial Inferior Epigastric Artery Flaps

Henry, Steven L.; Huang, Jung‐Ju; Cheng, Ming Huei

doi:10.1097/sap.0b013e3181b0224c

Cited by 7 publications

(4 citation statements)

References 25 publications

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“…[29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45] Ten authors of the 29 studies with missing data replied to the email request but were unable to provide additional data. [46][47][48][49][50][51][52][53][54][55] No response was received from the remaining 16 authors. [56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71]…”

Section: Resultsmentioning

confidence: 99%

The increased risk of adverse outcomes in bilateral deep inferior epigastric artery perforator flap breast reconstruction compared to unilateral reconstruction: A systematic review and meta-analysis

Wormald

Wade

Figus

2014

Journal of Plastic, Reconstructive & Aesthetic Surgery

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The current literature related to DIEP flap breast reconstruction appears to be of low quality. However, this is the first systematic review confirming that bilateral DIEP flap breast reconstruction is associated with a significantly higher risk of total flap failure compared to unilateral DIEP flap breast reconstruction. This review will allow clinicians to better inform patients of the risks of adverse outcomes in DIEP flap breast reconstruction. It also highlights the need for higher quality research in this area.

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Section: Resultsmentioning

confidence: 99%

The increased risk of adverse outcomes in bilateral deep inferior epigastric artery perforator flap breast reconstruction compared to unilateral reconstruction: A systematic review and meta-analysis

Wormald

Wade

Figus

2014

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Section: Discussionmentioning

confidence: 99%

“…Deep inferior epigastric artery perforator flap is the criterion standard for autologous breast reconstruction, which has many advantages to ensure low failure rate and minimize donor site morbidity. [6][7][8][9] The definition of zone I to IV is helpful for flap design and transfer to be at minimal risk for partial flap loss or fat necrosis; corresponding techniques were reported to improve the vascularity of flap. 1,10,11 However, although the development of microsurgical management and anatomical technique has optimized the DIEP flap approach, there are still some problems and flaw issues that need to be addressed.…”

Section: Discussionmentioning

confidence: 99%

The Role of Measurement of Pedicle Length for DIEP Flap Transferring in Breast Reconstruction

Song

Pafitanis

et al. 2021

Ann Plast Surg

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BackgroundIntraoperative venous congestion is a main complication in deep inferior epigastric artery perforator (DIEP) flap for breast reconstruction. We present a pedicle measuring technique to precisely predict the length of pedicle needed in DIEP free flap, to improve the outcome, and to reduce the risk of donor site morbidity and complications.Materials and MethodsA single-center, open-label, prospective, randomized study was carried out to access efficacy and safety of a pedicle measuring technique in 389 patients. Each patient received a delayed breast reconstruction using free unipedicled DIEP flap, and internal mammary vessels were chosen as recipient vessels. During the surgery, the conventional DIEP flap technique was used in the control group, in which the course of the pedicle was fully dissected. In the measuring group, the flap in setting way was decided preoperatively, the distance (A) between the internal mammary vessels (a) and the point of DIEP perforator into the subcutaneous tissue (b) was measured, and then the length (B) of the perforator (c) and the main trunk (d) is measured and dissected to achieve 1 cm longer than A.ResultsThere are 180 and 209 patients enrolled in the control and measuring group, respectively. Venous congestion occurred in 15 patients (8.3%) in the control group, and 1 patient (0.5%) in the measuring group (P < 0.001). All the 16 patients were found venous thrombosis. Then successful free flap salvage surgeries were performed in 10 patients. Six patients (3.3%) had total flap necrosis due to recurrent venous thromboembolisms. Fat necrosis occurred in 16 patients (8.9%) in the control group, and 5 patients (2.4%) in the measuring group (P = 0.006). Partial flap necrosis was found in 12 patients (6.7%) in the control group, and in 3 patients (1.4%) in the measuring group (P = 0.008). Total flap necrosis occurred in 6 patients (3.3%) in the control group, but no (0%) patient in the measuring group (P = 0.009).ConclusionsMeasurement of pedicle length for DIEP flap transferring in breast reconstruction is a reliable technique that could secure the DIEP free flap, reduce operative invasiveness, and lower the risk of complications considerably.

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“…71 Until recent, a free flap was only rarely reported as salvage procedure after failed breast implant augmentation. 72 In February 2023, Martinez and Boutros presented a series of eleven patients who successfully underwent bilateral cosmetic breast augmentation with DIEP flaps. 73 Perhaps in future, if autologous tissue transplants may become cheaper and can be performed faster, free flap breast augmentation may eventually compete with the current golden standard of breast augmentations using silicone breast implants.…”

Section: In Breast Augmentationmentioning

confidence: 99%

The Female Breasts .. more or less

Bouwer¹

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BackgroundA retrospective study was undertaken to evaluate whether the initial outcome of two types of reduction mammaplasty techniques (vertical scar reduction mammaplasty vs.the inverted-T scar reduction mammaplasty) remains stable in the long term: MethodsSixty-nine patients who had undergone breast reduction surgery in the period 1997 -2000 at the Department of Reconstructive Plastic Surgery at the Medical Center of Leeuwarden were willing and able to participate in this study. A structured questionnaire was used to assess the degree of patient satisfaction. For subjective evaluation, the Strasser Grading System on photographs at the 3 months after surgery and after long-term follow-up (10 years) was used. ResultsThe median general appreciation mark for the entire surgical procedure given by patients was 8 (1-10) on a scale from 1 to 10. Forty-six of the 69 patients could be scored according to Strasser: at 3 months in 17 patients (37%) the result was 'good', in 21 patients (46%) 'mediocre' and in eight patients (17%) 'poor'. After 10 years, in 37 of the patients (80%) the result was 'good', in six patients (13%) 'mediocre' and in three patients (7%) 'poor'. At 3 months, there was a higher incidence of bottoming out in the vertical scar group (50%) as compared to the inverted-T scar group (10%); however, at the 10-years follow-up bottoming out was 50% in the inverted-T scar group and 20% in the vertical scar group. ConclusionDespite bottoming out, in both the vertical scar reduction mammaplasty technique and the inverted-T scar reduction mammaplasty technique high patient satisfaction rates are achieved that remains for years. SUMMARY BackgroundAlmost every female shows some degree of breast asymmetry. A complete correction of asymmetry is not achievable; the best a surgeon can deliver is improvement of symmetry. This study was undertaken to evaluate to which extent breast asymmetry is influenced by dual-sided breast surgery and whether there is difference between breast augmentation and breast reduction surgery. MethodsOf fifty breast augmentation and fifty breast reduction patients, the pre-and postoperative photographs were evaluated on several aspects of asymmetry by a scoring panel. ResultsPreoperatively, significantly more breast asymmetry was found in the breast reduction group; the total preoperative asymmetry score was 1.7 in the breast augmentation group compared to 3.4 in the breast reduction group (p <0.001). The total asymmetry score after breast reduction improved 0.96 points (95% confidence interval [95%CI] -2.08 to 0.16), which was mainly driven by the significant improvement of breast volume asymmetry (-1.06; 95%CI -1.50 to -0.61). ConclusionsWe found more preoperative asymmetry in the breast reduction group than in the breast augmentation group. We showed that more improvement through surgery can be expected when preoperative asymmetries are more pronounced. Consequently, we found improvement of breast volume asymmetry scores in the breast reduction group, and a trend for improvement of the ...

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Bilateral Breast Revision Augmentation With Deep Inferior Epigastric Perforators/Superficial Inferior Epigastric Artery Flaps

Cited by 7 publications

References 25 publications

The increased risk of adverse outcomes in bilateral deep inferior epigastric artery perforator flap breast reconstruction compared to unilateral reconstruction: A systematic review and meta-analysis

The increased risk of adverse outcomes in bilateral deep inferior epigastric artery perforator flap breast reconstruction compared to unilateral reconstruction: A systematic review and meta-analysis

The Role of Measurement of Pedicle Length for DIEP Flap Transferring in Breast Reconstruction

The Female Breasts .. more or less

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