One‐stage DIEP flap breast reconstruction: Algorithm for immediate contralateral symmetrization. Issue 1 (2nd March 2015)

• Record Type: Journal Article
• Authors: Laporta, Rosaria; Longo, Benedetto; Sorotos, Michail; Pagnoni, Marco; Santanelli Di Pompeo, Fabio
• Is Part Of: Microsurgery. Volume 36:Issue 1(2016)
• Page Start: 7
• Page End: 19
• Publication Date: 2015-03-02
• Subjects: Microsurgery -- Periodicals; 617.05
• DOI: 10.1002/micr.22390
• Languages: English
• ISSNs: 0738-1085

Abstract

Abstract : The aim of this study was to investigate clinical and aesthetic results of simultaneous contralateral balancing procedures in unilateral DIEP flap reconstructions by means of a symmetrization algorithm. Between 2004 and 2013, 335 patients underwent DIEP flap breast reconstruction with 48 patients (mean age 51.8 years, range 32–69 years) undergoing contralateral procedure. Patients were divided in Group‐A including 31 cases who underwent one‐stage procedure and Group‐B including 17 cases who underwent staged procedure. A symmetrization algorithm was proposed to plan immediate breast reduction/mastopexy. The groups were homogeneous regarding patient's age, BMI, mastectomy and flap weight ( P > 0.05). All flaps survived. No complications were observed to the mastectomy skin flaps and to the reduction mammaplasty/mastopexy procedures in both groups. The mean operation time was 5 h in Group‐A while 5 h and 37 min in Group‐B ( P = 0.0682). Contralateral procedures included 23 breast reductions and 8 mastopexies in Group‐A, while 10 breast reductions and 7 mastopexies were performed in Group‐B. Two and 6 patients required revision of the balancing procedure in Group‐A and Group‐B, respectively. The follow‐up time was 47.3 months (range 14–120 months) in Group‐A and 91.3 months (range 41–110 months) in Group‐B. Volume, upper/lower pole shape, projection, breast mound placement, IMF, symmetry, overall appearance, and general satisfaction sub‐items obtained high‐score evaluation without significant difference between the two groups ( P > 0.05). One‐stage DIEP flap reconstruction by means of the symmetrization algorithm resulted in comparable aesthetic outcomes and patient satisfaction to a staged procedure. © 2015 Wiley Periodicals, Inc. Microsurgery 36:7–19, 2016.