The Stacked Hemiabdominal Extended Perforator Flap for Autologous Breast Reconstruction

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Microsurgery

Background:

• Bilateral autologous breast reconstruction options are limited for thin women.
• The stacked hemiabdominal extended perforator (SHAEP) flap is a novel approach to augment abdominal flap volume.

Purpose of the Study:

• To introduce and analyze the surgical technique and outcomes of the SHAEP flap for breast reconstruction.

Main Methods:

• Retrospective study of SHAEP flap breast reconstructions since February 2014.
• Flap design involved combining deep inferior epigastric artery perforator (DIEP) with other perforator vessels.
• Data collected included patient demographics, operative details, complications, and reexplorations.

Main Results:

• 90 SHAEP flap reconstructions in 49 patients were performed.
• Median flap weight was 598 g, with no total flap losses.
• Recipient-site complications were low, including partial flap loss (2.2%) and hematoma (3.3%).

Conclusions:

• The SHAEP flap is an excellent option for bilateral autologous breast reconstruction in women needing significant volume with limited abdominal tissue.
• The bipedicled SHAEP flap enhances perfusion, increases volume, and improves abdominal contour.
• This technique utilizes a single abdominal donor site for increased flap volume.