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An Algorithmic Approach to Umbilical Inset during DIEP Flap Reconstruction.

Kelly P Schultz1, James A Mentz1, Edward Reece1

  • 1From the Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine; Department of Plastic Surgery, University of Texas M. D. Anderson Cancer Center; and Division of Plastic Surgery, Department of Surgery, McGill University.

Plastic and Reconstructive Surgery
|September 26, 2022
PubMed
Summary

This study presents an algorithm to improve the aesthetic appearance of the neoumbilicus after deep inferior epigastric artery perforator (DIEP) flap breast reconstruction. The approach minimizes umbilical complications and enhances abdominal donor site cosmesis for better patient satisfaction.

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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Breast Reconstruction

Background:

  • Aesthetic umbilical appearance is crucial for patient satisfaction after DIEP flap breast reconstruction.
  • DIEP flap patients face higher risks of umbilical complications and poor neoumbilicus aesthetics compared to abdominoplasty patients.
  • Factors like body habitus, comorbidities, and surgical technique influence outcomes.

Purpose of the Study:

  • To propose an algorithmic approach for umbilical inset in DIEP flap reconstruction.
  • To minimize umbilical complications and optimize abdominal donor site aesthetics.
  • To enhance overall patient satisfaction by improving neoumbilicus appearance.

Main Methods:

  • Development of a standardized algorithm for umbilical inset.
  • Consideration of key factors: subcutaneous tissue thickness, umbilical stalk length, and umbilical bowl depth.
  • Application of the algorithm during DIEP flap harvest.

Main Results:

  • The proposed algorithm serves as a practical tool for surgeons.
  • It aids in reducing the incidence of umbilical complications.
  • It contributes to a superior cosmetic outcome for the abdominal donor site.

Conclusions:

  • The algorithmic approach effectively addresses challenges in neoumbilicus creation.
  • It leads to improved aesthetic results and patient satisfaction in DIEP flap breast reconstruction.
  • This method is valuable for optimizing the abdominal donor site in reconstructive procedures.