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Bilateral breast reconstruction with DIEP flaps: 4 years’ experience

Bilateral breast reconstruction with DIEP flaps: 4 years’ experience

Authors :
Igor Stupka
Ivan Justan
P Hyza
Fabio Castagnetti
Pavel Novák
Nicola Monni
Lubos Drazan
Jiri Vesely
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.

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