Bilateral breast reconstruction with DIEP flaps: 4 years' experience

Area of Science:

• Plastic Surgery
• Oncology
• Reconstructive Surgery

Background:

• Bilateral prophylactic mastectomy necessitates reliable breast reconstruction.
• Autologous reconstruction options are varied, with the DIEP flap being a key consideration for bilateral cases.

Purpose of the Study:

• To assess the feasibility and patient acceptance of bilateral deep inferior epigastric perforator (DIEP) flap reconstruction.
• To evaluate outcomes and complications associated with this procedure.

Main Methods:

• A review of 55 consecutive patients undergoing bilateral DIEP flap reconstruction over a 4-year period.
• Inclusion of medical chart review, clinical assessments, and anonymous patient questionnaires.
• Documentation of immediate versus delayed reconstructions and any flap conversions.

Main Results:

• 100% flap survival with no microanastomosis revisions.
• 10% conversion rate to mini transverse rectus abdominis muscle (miniTRAM) flap to ensure adequate blood supply.
• High patient satisfaction with aesthetic outcomes (96.2% good or excellent) and improved quality of life in over 50% of cases.

Conclusions:

• Bilateral DIEP flap reconstruction is a feasible and well-accepted procedure for patients undergoing prophylactic mastectomy.
• The DIEP flap offers excellent aesthetic results and enhances patient quality of life.
• Occasional conversion to miniTRAM flap can optimize overall flap survival rates.