ArticlePlastic and reconstructive surgery. Global open2024
DIEP Flap Weights in Immediate 1-stage and 2-stage Breast Reconstruction: Considering Chest Wall Deformity.
Article in Plastic and reconstructive surgery. Global open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
Background: There are advantages and disadvantages to both immediate 1-stage and 2-stage autologous-breast reconstruction. The 2-stage procedure may suffer from a hitherto overlooked difficulty: the tissue expander may induce chest wall depression that may require using a heavier-than-expected flap to generate symmetrical breasts. We conducted a retrospective observational study to assess this phenomenon. Methods: Consecutive patients who underwent 1-stage or 2-stage unilateral autologous-breast reconstruction with a deep inferior epigastric perforator flap were included. The 2 groups were compared in terms of age, body mass index, mastectomized tissue weight, inset-flap weight, and percentage additional flap weight (defined as [inset-mastectomy]/mastectomy × 100). The latter reflects the amount of additional flap tissue relative to mastectomized tissue that was needed to generate symmetrical breasts. The chest wall deformity after tissue expansion in the 2-stage patients was quantitated with computed tomography. Results: Patients' healthy and affected breasts were symmetrical before surgery ( Conclusions: Due to tissue expander-induced chest wall deformity, 2-stage breast reconstruction may require a larger flap volume than is anticipated on the basis of preoperative volumetric measurements. Considering this phenomenon when choosing between immediate 1-stage and 2-stage reconstruction could potentially help improve patient outcomes.
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