One-stage DIEP flap breast reconstruction: Algorithm for immediate contralateral symmetrization

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Breast Reconstruction

Background:

• Unilateral DIEP flap breast reconstruction often requires contralateral balancing for symmetry.
• Assessing clinical and aesthetic outcomes of simultaneous contralateral procedures is crucial.

Purpose of the Study:

• To investigate clinical and aesthetic results of simultaneous contralateral balancing procedures in unilateral DIEP flap reconstructions.
• To evaluate the efficacy of a symmetrization algorithm for planning these procedures.

Main Methods:

• Retrospective analysis of 48 patients undergoing unilateral DIEP flap reconstruction with contralateral balancing (2004-2013).
• Patients divided into one-stage (Group-A, n=31) and staged (Group-B, n=17) procedures.
• A symmetrization algorithm was used for planning immediate breast reduction/mastopexy.

Main Results:

• All flaps survived with no complications to mastectomy skin flaps or reduction mammaplasty/mastopexy.
• Comparable aesthetic outcomes and patient satisfaction were observed between one-stage and staged procedures.
• Mean operation time was similar (5h vs 5h 37min), with lower revision rates in the one-stage group.

Conclusions:

• One-stage DIEP flap reconstruction with contralateral balancing using a symmetrization algorithm achieves comparable aesthetic results and patient satisfaction to staged procedures.
• The symmetrization algorithm aids in planning effective and safe contralateral balancing procedures.
• This approach offers a viable option for achieving symmetry in unilateral breast reconstruction.