ArticleAesthetic plastic surgery2026
Volumetric Feasibility of Lumbar Artery Perforator Flaps Compared to Abdominal Flaps for Breast Reconstruction in Low-BMI Patients: A CT-Based Study.
Article in Aesthetic plastic surgery, 2026. 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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3 authors.
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Abstract
backgroundAlthough abdominal flaps remain the gold standard for autologous breast reconstruction, their use in low-BMI patients-particularly in bilateral cases or when matching a contralateral large breast-can be limited by concerns about insufficient volume. The lumbar artery perforator (LAP) flap has emerged as a potential alternative. This study evaluated its volumetric adequacy in lean patients using computed tomographic angiography (CTA)-based analysis.
methodsBetween 2019 and 2024, patients with BMI ≤ 25 who underwent abdominal flap-based breast reconstruction were retrospectively reviewed. Flap volumes were assessed using CTA. LAP flap volumes were compared with (1) 50% of estimated abdominal flap volume to simulate bilateral reconstruction and (2) estimated abdominal flap volumes based on inset rates from bipedicled cases. Comparisons were stratified by BMI: < 23 and 23-25.
resultsA total of 177 patients were included. The estimated abdominal and LAP flap volumes were 695.0 and 486.6 cm
conclusionsThe LAP flap volume was found to be comparable to that of the abdominal flap in a meaningful proportion of lean patients. These findings suggest it may serve as a reasonable alternative in cases requiring bilateral or bipedicled abdominal flap reconstruction. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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