The Donut DIEP Flap: A Novel Scarless Technique

Area of Science:

• Plastic Surgery
• Surgical Techniques
• Breast Reconstruction

Background:

• Deep Inferior Epigastric Perforator (DIEP) flap surgery is a standard for breast reconstruction.
• A significant drawback of DIEP flap surgery is the long, noticeable abdominal scar.
• Minimizing donor-site morbidity and improving aesthetic outcomes are key goals in DIEP flap procedures.

Purpose of the Study:

• To present a novel minimal scarring technique for Deep Inferior Epigastric Perforator (DIEP) flap harvest.
• To describe a new abdominal design aimed at reducing the visible scar after breast reconstruction.
• To evaluate the feasibility and aesthetic potential of a circular abdominal incision for DIEP flap donor sites.

Main Methods:

• A novel circular abdominal design centered around the umbilicus was employed for DIEP flap harvest.
• Three concentric circular incisions were utilized, preserving a central skin paddle.
• The dissection extended diagonally to the Scarpa fascia, followed by conventional pedicle dissection.
• Closure involved a purse-string suture, centering the umbilicus to create a single circular scar.

Main Results:

• The described technique results in a single, small circular scar around the umbilicus.
• Preservation of more skin tissue is achieved through the circular design.
• The modified closure allows for donor-site closure in supine or slightly flexed positions due to reduced skin excision.

Conclusions:

• This minimal scarring DIEP flap harvest technique offers a promising alternative for breast reconstruction.
• The novel abdominal design effectively minimizes the visible scar, addressing a major disadvantage of traditional DIEP flaps.
• The technique provides a favorable aesthetic outcome for the abdominal donor site in breast reconstruction patients.