Congenital Breast Deformity Reconstruction Using Perforator Flaps

A Classification System for Partial and Complete DIEP Flap Necrosis Based on a Review of 17,096 DIEP Flaps in 693 Articles Including Analysis of 152 Total Flap Failures

“…41 Most authors considered skin loss between 10 and 20 percent 17,18,20,42-45 as their cutoff for inclusion, although some authors labeled flaps with less than 5 percent skin loss as "partial necrosis," 46,47 and others categorized skin loss greater than 20 percent as "partial necrosis." 19,35,39,48 Fat necrosis had a range of definitions, including (1) absolute size (lumps >0.5 cm, 49 >1 cm, 6,25,39,50 >2 cm, 15,40,51 >3 cm 16 confirmed not to be malignant recurrence) detected clinically or by ultrasound 49,52,53 and/or mammography 46,54 , (2) proportion of volume of flap 18,43 , and (3) incidence of secondary operations to address fat necrosis.. 21,22,[55][56][57] Other authors chose to describe necrosis as "minor," 58 "minimal," 59 or "limited." 60 Another variable in fat necrosis reporting was the time frame-many authors reported detection rates at 2 39 to 3 6,15 months after the initial reconstruction, but others reported rates at 1 month 41 or even 1 year.…”

Autologous Reconstruction of a Complex Form of Poland Syndrome Using 2 Abdominal Perforator Free Flaps

“…6 Careful assessment of recipient vessels is recommended to detect any anomaly of the internal mammary vessels and subscapular vascular system. 4 Because of the high-quality of abdominal tissue, DIEP f lap is considered as the first choice for breast and chest wall reconstruction.…”