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Enhancing Volume Precision in Breast Reconstruction: A BMI-Based Model for Predicting Flap Weight in Profunda Artery
Charalampos Varnava1,2,3, Shaghayegh Gorji1,2,3, Sascha Wellenbrock1,2,3
1Department of Plastic Surgery, University Hospital Muenster, 48149 Muenster, Germany.
Life (Basel, Switzerland)
|April 26, 2025
Summary
The profunda artery perforator (PAP) flap is effective for breast reconstruction. A new algorithm predicts PAP flap volume using body mass index (BMI), aiding surgical planning even in patients with lower BMI.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Oncology
Background:
- Profunda artery perforator (PAP) flap is a recognized technique for autologous breast reconstruction.
- It offers low donor site morbidity and favorable outcomes.
- Recent advancements focus on refining PAP flap use, particularly in preoperative volume prediction.
Purpose of the Study:
- To highlight recent refinements in PAP flap breast reconstruction.
- To focus on preoperative volume prediction using a novel algorithm.
- To assess the correlation between body mass index (BMI) and flap weight.
Main Methods:
- Retrospective study of 114 PAP flaps in 96 patients (May 2018 - December 2022).
- Statistical analysis of flap volume in relation to BMI.
- Collection of surgical details, donor site complications, and patient characteristics.
Main Results:
- BMI is a statistically significant predictor of flap weight (p < 0.001).
- The developed predictive model is: flap weight (g) = (19.252 × BMI) - 143.572.
- Adequate flap volume can be harvested even in patients with low BMI.
Conclusions:
- Preoperative PAP flap volume can be reliably predicted using BMI.
- An algorithm was developed to enhance preoperative planning and estimate the need for supplementary procedures.
- This facilitates achieving desired breast reconstruction volume.
