The authors are to be commended for sharing their experience and excellent results using perforator flaps for breast reconstruction. They expand on an idea that has been previously reported – successfully using abdominal tissue as donor site for perforator flaps even though it may have been injured due to prior surgical scars and/or liposuction.
- Karanas Y.L.
- Santoro T.D.
- Da Lio A.L.
- et al.
Free TRAM flap breast reconstruction after abdominal liposuction.
Plast Reconstr Surg. 2003; 112: 1851-1854
2Furthermore, they push the envelope by performing two microsurgical procedures using this previously operated donor site to reconstruct one breast. Alternative donor site tissue or reconstructive technique is usually selected by microsurgeons when abdominal tissue is inadequate or potentially damaged. They report sixteen patients (32 flaps, average BMI 20.8, 5 pts: midline scar, 3 pt: prior liposuction) underwent double pedicled abdominal perforator flaps for unilateral breast reconstruction. Average operative time was a reasonable 6 h and 30 min. Flaps were ‘piggybacked’ microsurgically to another flap in order to restore adequate mastectomy defect volume. The presented case examples demonstrate impressive postoperative results.
- Kim J.Y.
- Chang D.W.
- Temple C.
- et al.
Free transverse rectus abdominis musculocutaneous flap breast reconstructions in patients with prior abdominal suction-assisted lipectomy.
Plast Reconstr Surg. 2004; 113: 28e-31e
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- Free TRAM flap breast reconstruction after abdominal liposuction.Plast Reconstr Surg. 2003; 112: 1851-1854
- Free transverse rectus abdominis musculocutaneous flap breast reconstructions in patients with prior abdominal suction-assisted lipectomy.Plast Reconstr Surg. 2004; 113: 28e-31e
- Deep inferior epigastric perforator flap for breast reconstruction.Ann Plast Surg. 1994; 32: 32-38
- Breast reconstruction with free bipedicled TRAM or DIEP flaps by anastomosis to the proximal and distal ends of the internal mammary vessels.Semin Plast Surg. 2002; 16: 61-68
- Breast reconstruction with the deep inferior epigastric perforator flap: history and an update on current technique.J Plast Reconstr Aesthet Surg. 2006; 59: 571-579
- Breast reconstruction with gluteal artery perforator flaps.J Plast Reconstr Aesthet Surg. 2006; 59: 614-621
Published online: May 17, 2007
Accepted: March 23, 2007
Received: March 9, 2007
© 2007 Published by Elsevier Inc.
ScienceDirectAccess this article on ScienceDirect
- Double-pedicle abdominal perforator free flaps for unilateral breast reconstruction: new horizons in microsurgical tissue transfer to the breastJournal of Plastic, Reconstructive & Aesthetic SurgeryVol. 60Issue 8
- PreviewThe DIEAP (deep inferior epigastric artery perforator) flap is a suitable option for breast reconstruction resulting in excellent aesthetic outcome, and minimal donor site morbidity. Contraindications for use of the DIEAP flap may include previous abdominal liposuction and/or surgery, or lack of abdominal tissue. The purpose of this paper is to describe options of using abdominal perforator flaps, based on double-pedicle techniques, despite these contraindications. A retrospective evaluation was carried out on a series of 16 patients who required abdominal double-pedicle free perforator flaps for unilateral breast reconstruction since June 2002.