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Bilateral breast reconstruction with DIEP flaps: 4 years’ experience
Bilateral breast reconstruction with DIEP flaps: 4 years’ experience
- Source :
- Journal of Plastic, Reconstructive & Aesthetic Surgery. 61:1309-1315
- Publication Year :
- 2008
- Publisher :
- Elsevier BV, 2008.
-
Abstract
- Summary Bilateral prophylactic mastectomy without reconstruction is not accepted by the majority of patients. Successful reconstruction is therefore a mandatory condition for prophylactic mastectomy. Of the many options for autologous breast reconstruction, the deep inferior epigastric perforator (DIEP) flap best meets requirements for bilateral reconstruction in selected patients. The goal of this study is to verify the feasibility of the procedure in our conditions and to find out how it is accepted by patients. We present 55 consecutive patients who were scheduled for bilateral DIEP flap reconstruction during a 4-year period. We reviewed medical charts, performed clinical assessments and processed anonymous questionnaires. There were 77 immediate and 33 delayed breast reconstructions. There was 100% flap survival and no microanastomoses revisions. In 11 patients (10%) the surgeon preferred to convert the DIEP into a mini transverse rectus abdominis muscle (miniTRAM) flap in order to provide adequate blood supply. Complications: revision for haematoma under the flap in four patients (7.2%), excessive blood loss in four patients (7.2%) and partial mastectomy skin flap necrosis in 10 immediate breast reconstructions (12.9%). Patients' evaluation of the aesthetic result was good or excellent in 96.2% of cases. In 33.9% of patients the postoperative quality of life was considered unchanged and 50.9% of them it even improved. The DIEP flap is recommended for bilateral breast reconstruction. Occasional conversion into a miniTRAM flap can increase the total flap survival rate. Bilateral prophylactic mastectomy and DIEP flap reconstruction are very well accepted by patients.
- Subjects :
- Adult
medicine.medical_specialty
Esthetics
Mammaplasty
medicine.medical_treatment
Breast Neoplasms
Surgical Flaps
Postoperative Complications
DIEP flap
Humans
Medicine
Bilateral Prophylactic Mastectomy
Rectus abdominis muscle
Mastectomy
Retrospective Studies
business.industry
Retrospective cohort study
Prophylactic Mastectomy
Middle Aged
Surgery
Treatment Outcome
Patient Satisfaction
Quality of Life
Feasibility Studies
Female
business
Breast reconstruction
Subjects
Details
- ISSN :
- 17486815
- Volume :
- 61
- Database :
- OpenAIRE
- Journal :
- Journal of Plastic, Reconstructive & Aesthetic Surgery
- Accession number :
- edsair.doi.dedup.....8b63870b3b1648689815905feaa529e9
- Full Text :
- https://doi.org/10.1016/j.bjps.2007.06.028