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Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
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How Does Autologous Breast Reconstruction Impact Downtime?
Giovanni Zoccali1, Daniel Simon Rais2, Jian Farhadi1,2
1Department of Plastic and Reconstructive Surgery, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, United Kingdom.
Journal of Reconstructive Microsurgery
|April 14, 2018
Summary
Autologous breast reconstruction using Deep inferior epigastric perforator (DIEP) flaps offers the shortest recovery times compared to other flap types. Adjuvant therapies significantly prolong patient recovery, regardless of flap choice.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Oncology
Background:
- Autologous breast reconstruction provides superior outcomes but recovery times vary.
- Limited research exists on the impact of different flaps on patient recovery.
- This study assesses recovery durations for commonly used autologous reconstruction flaps.
Purpose of the Study:
- To evaluate and compare patient recovery times after autologous breast reconstruction using various flap types.
- To identify factors influencing recovery duration, including flap choice and adjuvant therapies.
Main Methods:
- 121 patients undergoing autologous breast reconstruction completed questionnaires on return-to-activity timelines.
- Statistical analysis included the analysis of variance F-test and odds ratio (OR) calculations.
Main Results:
- Recovery time varied widely (2.9-21.3 weeks) and was not solely dependent on flap type.
- Adjuvant chemotherapy added ~2 weeks, and radiotherapy added ~4 weeks to recovery.
- Deep inferior epigastric perforator (DIEP) flaps showed the highest odds of faster recovery, while transverse upper gracilis (TUG) flaps had the lowest.
Conclusions:
- DIEP flaps are recommended as the gold standard for autologous breast reconstruction due to shorter recovery.
- Adjuvant therapies significantly extend recovery periods.
- Flap selection should also consider surgical factors, patient lifestyle, and donor site availability.
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