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New microsurgical breast reconstruction using free paraumbilical perforator adiposal flaps
I Koshima1, K Inagawa, M Yamamoto
1Department of Plastic and Reconstructive Surgery at the Kawasaki Medical School, Kurashiki City, Okayama, Japan. plakos@med.kawasaki-m.ac.jp
Plastic and Reconstructive Surgery
|July 7, 2000
Summary
Free paraumbilical perforator adiposal flaps offer a minimally invasive alternative for breast reconstruction after mastectomy. This technique preserves rectus abdominis muscles, avoiding complications like abdominal bulging and lumbar pain associated with traditional TRAM flaps.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Microsurgery
Background:
- Pedicled transverse rectus abdominis musculocutaneous (TRAM) flaps are common for bilateral breast reconstruction.
- TRAM flaps can lead to rectus abdominis muscle loss, abdominal bulging, and lumbar pain.
Purpose of the Study:
- To evaluate a new minimally invasive breast augmentation technique using free paraumbilical perforator adiposal flaps.
- To assess the feasibility of this method in patients with prior bilateral mastectomy and prostheses.
Main Methods:
- Utilized free paraumbilical perforator adiposal flaps for simultaneous breast reconstruction.
- Employed supermicrosurgery with anastomosis of 0.5-mm caliber vessels.
- Preserved the rectus abdominis muscle during the procedure.
Main Results:
- Successful simultaneous breast reconstruction in a 57-year-old female patient.
- The procedure avoided rectus abdominis muscle sacrifice.
- Demonstrated a minimally invasive approach with short flap elevation time.
Conclusions:
- Free paraumbilical perforator adiposal flaps provide a viable, muscle-sparing alternative for breast reconstruction.
- This technique overcomes major disadvantages of traditional TRAM flaps.
- Offers advantages of minimally invasive surgery and preservation of abdominal wall integrity.