Aesthetical outcome after breast reconstruction using deep inferior epigastric perforator flap: Personal techniques

 

PDF Download Permissions and Reprints

ABSTRACT

Background: Now-a-days, deep inferior epigastric perforator (DIEP) flap breast reconstruction is widespread throughout the world. The aesthetical result is very important in breast reconstruction and its improvement is mandatory for plastic surgeons. Materials and Methods: The most frequent problems, we have observed in breast reconstruction with DIEP flap are breast asymmetry in terms of volume and shape, the bulkiness of the inferior lateral quadrant of the new breast, the loss of volume of the upper pole and the lack of projection of the inferior pole. We proposed our personal techniques to improve the aesthetical result in DIEP flap breast reconstruction. Our experience consists of more than 220 DIEP flap breast reconstructions. Results: The methods mentioned for improving the aesthetics of the reconstructed breast reported good results in all cases. Conclusion: The aim of our work is to describe our personal techniques in order to correct the mentioned problems and improve the final aesthetical outcome in DIEP flap breast reconstruction.

• 1 Allen RJ, Treece P. Deep inferior epigastric perforator flap for breast reconstruction. Ann Plast Surg 1994;32:32-8.
• 2 Alderman AK, Wilkins EG, Lowery JC, Kim M, Davis JA. Determinants of patient satisfaction in postmastectomy breast reconstruction. Plast Reconstr Surg 2000;106:769-76.
• 3 Atisha D, Alderman AK, Lowery JC, Kuhn LE, Davis J, Wilkins EG. Prospective analysis of long-term psychosocial outcomes in breast reconstruction: Two-year postoperative results from the michigan breast reconstruction outcomes study. Ann Surg 2008;247:1019-28.
• 4 Blondeel PN, Hijjawi J, Depypere H, Roche N, Van Landuyt K. Shaping the breast in aesthetic and reconstructive breast surgery: An easy three-step principle. Plast Reconstr Surg 2009;123:455-62.
• 5 Enajat M, Smit JM, Rozen WM, Hartman EH, Liss A, Kildal M, et al. Aesthetic refinements and reoperative procedures following 370 consecutive DIEP and SIEA flap breast reconstructions: Important considerations for patient consent. Aesthetic Plast Surg 2010;34:306-12.
• 6 Munhoz AM, Ishida LH, Duarte GG, Cunha MS, Montag E, Sturtz G, et al. Aesthetic refinements in breast augmentation with deep inferior epigastric perforator flap: A case report. Aesthetic Plast Surg 2003;27:107-11.
• 7 Coleman SR. Structural fat grafting. Aesthet Surg J 1998;18:386, 388.
• 8 Allen RJ, Heitland AS. Autogenous augmentation mammaplasty with microsurgical tissue transfer. Plast Reconstr Surg 2003;112:91-100.
• 9 Huang JJ, Chao LF, Wu CW, Nguyen DH, Valerio IL, Cheng MH. Simultaneous scarless contralateral breast augmentation during unilateral breast reconstruction using bilateral differentially split DIEP flaps. Plast Reconstr Surg 2011;128:593e-604.
• 10 Drazan L, Vesely J, Hyza P, Castagnetti F, Stupka I, Justan I, et al. Bilateral breast reconstruction with DIEP flaps: 4 years experience. J Plast Reconstr Aesthet Surg 2008;61:1309-15.
• 11 Delay E, Garson S, Tousson G, Sinna R. Fat injection to the breast: Technique, results, and indications based on 880 procedures over 10 years. Aesthet Surg J 2009;29:360-76.