Enhancing Breast Reshaping in Massive Weight Loss Patients: The Post-Bariatric DIEP Approach

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Bariatric Surgery

Background:

• Massive weight loss (MWL) often leads to breast ptosis and altered skin quality.
• Silicone prostheses have a high recurrence rate for ptosis in MWL patients.
• Deep Inferior Epigastric Perforator (DIEP) flaps can address simultaneous breast and abdominal deformities.

Purpose of the Study:

• To evaluate the DIEP-free flap as an autologous breast prosthesis for volumetric augmentation in postbariatric patients.
• To assess patient satisfaction and outcomes following this reconstructive procedure.

Main Methods:

• Retrospective study of postbariatric patients undergoing breast reshaping with double DIEP-free flaps.
• Evaluation of patient demographics, operative details, and postoperative outcomes.
• Preoperative and 6-month postoperative BREAST-Q and BODY-Q surveys for satisfaction assessment.

Main Results:

• Twenty patients (average age 30, average weight loss 52.2 kg) underwent the procedure.
• Average surgery duration was 461.38 min, with a 6.5-day hospital stay.
• Two flaps required revision, one flap was lost; two donor site complications occurred.
• Significant improvements in satisfaction with breast appearance and overall well-being were noted.

Conclusions:

• DIEP flap is a safe and reproducible technique for postbariatric breast deformities.
• Autologous volumetric augmentation provides stable, long-term aesthetic outcomes.
• The procedure avoids secondary sequelae at the donor site.