[Delayed breast reconstruction using DIEP flap without skin paddle: Technique, evaluation and management]

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Breast Reconstruction

Context:

• Delayed breast reconstruction (DBR) often uses the deep inferior epigastric perforator (DIEP) flap.
• The conventional skin paddle technique can lead to aesthetic issues like the "patch" effect.
• A novel three-stage approach is proposed to address these aesthetic concerns.

Purpose:

• To evaluate the safety and efficacy of a three-stage DBR method.
• To assess the outcomes of initial prosthetic reconstruction with abdominal advancement flap and subsequent conversion to a buried DIEP flap.
• To compare this technique with traditional skin paddle methods.

Summary:

• Eighty-two patients underwent the protocol, with 19.5% experiencing initial prosthesis-related complications.
• 87.8% proceeded to DIEP flap reconstruction with complete burial, requiring an average of 1.39 touch-ups.
• 6.09% were satisfied with prosthetic reconstruction and did not proceed to flap conversion.

Impact:

• The buried DIEP flap technique offers a safe and reproducible aesthetic alternative for DBR.
• This strategy effectively manages complications and improves patient satisfaction.
• The study highlights the potential of this approach in overcoming the limitations of traditional DIEP flap reconstruction.