1,275 results match your criteria Breast Reconstruction Perforator Flap


Malignant Phyllodes Tumor Recurrence in the Pleural Cavity via the Deep Inferior Epigastric Perforator Flap and Internal Mammary Vessel Bundle: A Case Report.

Ann Plast Surg 2019 Mar 13. Epub 2019 Mar 13.

Division of General Surgery, Department of Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan.

We report a rare case that after rapid recurrence there was pathological transition from a fibroadenoma and benign phyllodes tumor to borderline and malignant phyllodes tumor. Another rare finding included tumor dissemination in the pleural cavity via reconstructed deep inferior epigastric perforator flap edge and internal mammary vessel bundle. Hence, we eliminated the use of internal mammary vessel bundle as the recipient vessel for free-flap reconstruction to avoid recurrence in the pleural cavity. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001795DOI Listing

Unilateral Reconstruction of the Large Breast: Combining Prosthetic and Autologous Methods for Improved Symmetry.

Plast Reconstr Surg Glob Open 2019 Feb 11;7(2):e2154. Epub 2019 Feb 11.

Georgia Breast Surgery, PC, Lawrenceville, Ga.

Postmastectomy reconstruction in patients with significant macromastia and/or large chest wall dimensions can be challenging. Implants have a limited size range and may not be large enough to adequately reconstruct a wide, obese patient. Abdominally based flaps may be unsafe in these patients if they have significant obesity and or other comorbidities and may still be insufficient to adequately fill a very large breast footprint. Read More

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http://dx.doi.org/10.1097/GOX.0000000000002154DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6416119PMC
February 2019

Anatomical Considerations to Optimize Sensory Recovery in Breast Neurotization with Allograft.

Plast Reconstr Surg Glob Open 2018 Nov 7;6(11):e1985. Epub 2018 Nov 7.

Plastic and Reconstructive Surgery, University of Ljubljana, Ljubljana, Slovenia, EU.

Background: Breast numbness is a recognized problem following mastectomy and subsequent reconstruction. Contemporary literature acknowledges the positive role of breast neurotization, but it is characterized by a variety of technical approaches and substantial heterogeneity with respect to the degree of recovered sensibility that remains suboptimal in comparison with other sensory nerve reconstructions. This study's purpose was to provide an anatomical basis for observed inconsistencies and therein provide a principle that can be used to develop a technical approach that will optimize sensory recovery. Read More

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http://dx.doi.org/10.1097/GOX.0000000000001985DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6414125PMC
November 2018
1 Read

Breast-sharing Technique in a Unilateral Mastectomy Patient.

Plast Reconstr Surg Glob Open 2018 Nov 13;6(11):e1976. Epub 2018 Nov 13.

Department of Plastic and Reconstructive Surgery, Máxima Medical Center, Veldhoven, The Netherlands.

Breast reconstruction patients frequently desire consecutive or simultaneous contralateral breast reduction. When combining the requirements of both autologous breast reconstruction with symmetrizing breast reduction, a 2-staged contralateral pedicled breast sharing is a dignified alternative. We present a 60-year-old woman with a radical mastectomy and adjuvant radiotherapy. Read More

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http://dx.doi.org/10.1097/GOX.0000000000001976DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6414112PMC
November 2018

Staged immediate nipple reconstruction with tube flap in secondary autologous breast reconstruction.

J Plast Surg Hand Surg 2019 Mar 14:1-4. Epub 2019 Mar 14.

a Department of Plastic and Reconstructive Surgery , Shanghai 9th People's Hospital, Shanghai JiaoTong University School of Medicine , Shanghai , P. R. China.

In the setting of secondary breast reconstruction by deep inferior epigastric artery perforator (DIEP) flap, the mastectomy skin is usually deepithelialized and buried under the reconstructed breast. In this study, by virtue of tube flap technique, we hypothesize that an amount of mastectomy skin could be transferred to the apex of reconstructed breast mound for nipple reconstruction. A total of 30 female postmastectomy patients were recruited between June 2012 and August 2015. Read More

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http://dx.doi.org/10.1080/2000656X.2019.1582423DOI Listing
March 2019
1 Read

Enhanced Recovery for Breast Reconstruction Surgery.

Curr Pain Headache Rep 2019 Mar 14;23(4):27. Epub 2019 Mar 14.

Department of Anesthesiology, LSU Health Science Center, 1542 Tulane Avenue, Suite 659, New Orleans, LA, 70112, USA.

Purpose Of Review: Enhanced recovery pathways are a well-described perioperative healthcare program involving evidence-based interventions. Enhanced recovery is designed to standardize techniques such as drug selection and nerve blocks in order to speed recovery and reduce overall hospital costs.

Recent Findings: A PubMed literature search was performed for articles that included the terms enhanced recovery and breast reconstruction surgery. Read More

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http://dx.doi.org/10.1007/s11916-019-0761-5DOI Listing

Effects of Antihypertensive Drugs on Outcomes of Breast Reconstruction.

Ann Surg Oncol 2019 Mar 12. Epub 2019 Mar 12.

Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

Background: Angiotensin receptor blocker (ARB), a commonly used antihypertensive drug, is reported to affect wound healing and flap survival in animal models. However, this has not been elucidated in a clinical series. This study aimed to investigate the impact that perioperative use of ARB has on outcomes after breast reconstruction. Read More

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http://dx.doi.org/10.1245/s10434-019-07293-zDOI Listing

Free Tissue Breast Reconstruction.

Semin Plast Surg 2019 Feb 8;33(1):59-66. Epub 2019 Mar 8.

Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas.

Free tissue transfer serves as a modern workhorse for breast reconstruction. Advancements in microsurgical technique have allowed for the development of free flap procedures that produce an aesthetic breast while minimizing donor site morbidity. Here, the authors review the use of different free flap procedures for breast reconstruction with a focus on the preferred and most commonly used flap, the deep inferior epigastric perforator flap. Read More

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http://dx.doi.org/10.1055/s-0039-1677703DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6408251PMC
February 2019
1 Read

Epidural Nerve Blocks Increase Intraoperative Vasopressor Consumption and Delay Surgical Start Time in Deep Inferior Epigastric Perforator Free Flap Breast Reconstruction.

Plast Reconstr Surg Glob Open 2019 Jan 15;7(1):e2105. Epub 2019 Jan 15.

Division of Plastic and Reconstructive Surgery, University of Ottawa, Ottawa, Ontario, Canada.

Background: Epidural nerve blocks (EA) have been widely used in abdominal and thoracic surgery as an adjunct to general anesthesia (GA). The role for EA in microsurgical free flap breast reconstruction remains unclear with concerns regarding its impact on flap survival and operating room efficiency. The purpose of this study was to examine the effectiveness of epidural blocks in patients undergoing deep inferior epigastric perforator (DIEP) flap breast reconstruction. Read More

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http://dx.doi.org/10.1097/GOX.0000000000002105DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382231PMC
January 2019

100 Steps of a DIEP Flap-A Prospective Comparative Cohort Series Demonstrating the Successful Implementation of Process Mapping in Microsurgery.

Plast Reconstr Surg Glob Open 2019 Jan 15;7(1):e2016. Epub 2019 Jan 15.

St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Mid Essex Hospital Services NHS Trust, Chelmsford, Essex, United Kingdom.

Background: The demand to improve the efficiency of microsurgical breast reconstruction is driven by increasing number of breast cancer and risk reducing cases, and the concurrent requirement for hospitals to cut costs. Businesses have successfully used process mapping as a tool to improve efficiency; however, process mapping has been sparsely used in surgery. This prospective cohort study has used process mapping to break down the individual components of a deep inferior epigastric artery perforator (DIEP) flap operation into a template of 100 streamlined steps. Read More

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http://dx.doi.org/10.1097/GOX.0000000000002016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382232PMC
January 2019
1 Read

Utilisation of contrast-enhanced magnetic resonance angiography in the assessment of deep inferior epigastric artery perforator flap for breast reconstruction surgery.

Clin Radiol 2019 Mar 1. Epub 2019 Mar 1.

Department of Plastic Surgery, Hull Royal Infirmary, Anlaby Road, HU3 2JZ, Hull, UK.

Aim: To identify and characterise the ideal-sized (defined as at least 2.7 mm based on the experience of plastic surgeons at Hull Royal Infirmary) perforators using magnetic resonance angiography (MRA). The study also evaluated a presumption that perforators on the left are generally larger than on the right. Read More

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http://dx.doi.org/10.1016/j.crad.2019.01.027DOI Listing
March 2019
1 Read

Stacked Profunda Artery Perforator Flap for Breast Reconstruction in Failed or Unavailable Deep Inferior Epigastric Perforator Flap.

Plast Reconstr Surg 2019 Mar;143(3):488e-494e

Dallas, Texas; and Philadelphia, Pa. From the Department of Plastic Surgery, University of Texas Southwestern Medical Center; and the Department of Surgery, Division of Plastic Surgery, Temple University.

Background: Recently, the profunda artery perforator flap has become one of the popular flap choices for patients who desire autologous breast reconstruction but are not optimal candidates for deep inferior epigastric perforator (DIEP) flap surgery. These patients are not ideal patients for DIEP flap surgery because of having poor perforators, previous abdominal operations, low body mass index, or previously used/failed DIEP flap. In their institution, the authors have performed stacked profunda artery perforator flaps for these patients to provide full volumetric and aesthetic reconstruction. Read More

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http://dx.doi.org/10.1097/PRS.0000000000005375DOI Listing
March 2019
3 Reads

Utility of Two Surgical Techniques Using a Lateral Intercostal Artery Perforator Flap after Breast-Conserving Surgery: A Single-Center Retrospective Study.

Plast Reconstr Surg 2019 Mar;143(3):477e-487e

Daegu, Republic of Korea From the Departments of Plastic and Reconstructive Surgery and Surgery, School of Medicine, Kyungpook National University.

Background: Immediate partial breast reconstruction after breast-conserving surgery has become a new paradigm in treating breast cancer. Among the volume replacement techniques used for small to moderate-sized breasts, the perforator flap method has many advantages. The authors present anatomical studies and two surgical techniques using lateral intercostal artery perforator flaps. Read More

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http://dx.doi.org/10.1097/PRS.0000000000005374DOI Listing
March 2019
8 Reads

[Sunburn of a reconstructed breast: risk of denervated tissue].

Ned Tijdschr Geneeskd 2019 Feb 15;163. Epub 2019 Feb 15.

HagaZiekenhuis, afd. Plastische en Reconstructieve Chirurgie, Den Haag.

More and more women opt for breast reconstruction with autologous tissue after breast removal. Reconstruction with a deep inferior epigastric perforator (DIEP) flap is the most common technique. In this operation, the nerves of the DIEP flap are cut. Read More

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February 2019
2 Reads

A comparison study of deep muscle sparing transverse rectus abdominis musculocutaneous flap for breast reconstruction.

Microsurgery 2019 Feb 25. Epub 2019 Feb 25.

Department of Plastic, Reconstructive and Aesthetic Surgery, Chiba University, Faculty of Medicine, Chiba, Chiba Prefecture, Japan.

Background: Breast reconstruction by deep inferior epigastric perforator flap (DIEP) involves only little rectus abdominis muscle sacrifice. However, the operative procedure may get complicated. We propose here a novel method involving two adjacent perforators and requiring the addition of only the superficial muscle to the flap. Read More

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http://dx.doi.org/10.1002/micr.30443DOI Listing
February 2019
3 Reads

Tertiary Breast Reconstruction for Salvage of the Failed Implant-Based Reconstruction Using the Deep Inferior Epigastric Perforator Flap.

J Reconstr Microsurg 2019 Feb 21. Epub 2019 Feb 21.

Department of Plastic and Reconstructive Surgery, North Bristol NHS Trust, Southmead Hospital, Bristol, United Kingdom.

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http://dx.doi.org/10.1055/s-0039-1679885DOI Listing
February 2019
1 Read

Objective evaluation of fat tissue induration after breast reconstruction using a deep inferior epigastric perforator (DIEP) flap.

J Plast Surg Hand Surg 2019 Feb 8:1-5. Epub 2019 Feb 8.

a Department of Plastic and Reconstructive Surgery , Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine , Kyoto , Japan.

Problems in breast reconstruction with deep inferior epigastric perforator (DIEP) flaps include postoperative fat induration and necrosis. A resulting clinical symptom is palpable indurated tissue, but it is difficult to measure the stiffness of transplanted fat tissues objectively at a deep site. The ability to perform shear-wave elastography (SWE) was recently added to some common ultrasonic echo devices, enabling objective three-dimensional measurements of tissue stiffness. Read More

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http://dx.doi.org/10.1080/2000656X.2018.1533839DOI Listing
February 2019
1 Read

Optimizing Perforator Selection in DIEP Flap Breast Reconstruction.

Plast Reconstr Surg 2019 Jan 22. Epub 2019 Jan 22.

Department of Plastic Surgery, UT Southwestern Medical Center, 1801 Inwood Road, Dallas, TX 75390-9132, Phone: 214-645-2353.

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http://dx.doi.org/10.1097/PRS.0000000000005458DOI Listing
January 2019

Optimizing Perforator Selection: A Multivariable Analysis of Predictors for Fat Necrosis and Abdominal Morbidity in DIEP Flap Breast Reconstruction.

Plast Reconstr Surg 2019 Jan 22. Epub 2019 Jan 22.

Department of Plastic Reconstructive Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G. Venezian 1, 20133 Milano, Italy.

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http://dx.doi.org/10.1097/PRS.0000000000005457DOI Listing
January 2019
1 Read

Mythbusting the DIEP Flap and An Introduction to the Abdominal Perforator Exchange (APEX) Breast Reconstruction Technique: A Single-Surgeon Retrospective Review.

Plast Reconstr Surg 2019 Jan 22. Epub 2019 Jan 22.

Background: Anatomic variations in perforator arrangement may impair the surgeon's ability to effectively avoid rectus muscle transection without impairing flap perfusion in the DIEP flap.

Methods: A single surgeon's experience was reviewed with consecutive patients undergoing bilateral abdominal perforator flap breast reconstruction over 6 years, incorporating flap standardization, pedicle disassembly, and algorithmic vascular rerouting when necessary. Unilateral reconstructions were excluded to allow for uniform comparison of operative times and donor site outcomes. Read More

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http://dx.doi.org/10.1097/PRS.0000000000005484DOI Listing
January 2019

Regional Anesthetic Blocks in Plastic Surgery Using Portable Ultrasound: A Simplified Approach.

Ann Plast Surg 2019 Jan 28. Epub 2019 Jan 28.

From the Division of Plastic and Reconstructive Surgery, Tulane University, New Orleans, LA.

Background: With the introduction of latest generation ultrasound technology and its easy availability and portability, regional anesthetic blocks, which were formally in the domain of anesthesiologists, have now become available to practicing plastic surgeons. Enhanced Recovery After Surgery protocols for other specialties such as orthopedics and colorectal surgery have incorporated regional anesthetic blocks. These regional blocks have been shown to be effective in improving the patient comfort and experience and decreasing reliance on opioid medications. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001805DOI Listing
January 2019

Successful free flap salvage upon venous congestion in bilateral breast reconstruction using a venous cross-over bypass: A case report.

Microsurgery 2019 Jan 28. Epub 2019 Jan 28.

Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.

Abdominal free flaps such as the muscle sparing transverse rectus abdominis myocutaneous (ms-TRAM) or deep inferior epigastric artery perforator (DIEP) flap represent the gold standard in autologous breast reconstruction. We describe a salvage procedure during bilateral free flap breast reconstruction due to insufficient venous drainage using a venous cross-over bypass. A 54-year-old woman with a thrombosis of the left subclavian port-system in the medical history was elected for simultaneous bilateral breast reconstruction with ms-TRAM and DIEP flaps. Read More

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http://dx.doi.org/10.1002/micr.30423DOI Listing
January 2019
4 Reads

The Role of CT Angiography in Assessing Deep Inferior Epigastric Perforator Flap Patency in Patients With Pre-existing Abdominal Scars.

J Surg Res 2019 Mar 23;235:58-65. Epub 2018 Oct 23.

Plastic & Reconstructive Surgery Department, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Cambridge Breast Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Anglia Ruskin University School of Medicine, Chelmsford & Cambridge, UK. Electronic address:

Background: Abdominal scars can affect the patency of deep inferior epigastric artery (DIEA) perforators and are a concern when planning free flap breast reconstruction (FFBR). Computed tomography angiography (CTA) is routinely used for preoperative DIEA flap imaging. We investigated CTA utility in predicting the most clinically useful DIEA perforators in scarred abdomens. Read More

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http://dx.doi.org/10.1016/j.jss.2018.09.059DOI Listing
March 2019
1 Read

A Head-to-Head Comparison of the Vascular Basis of the Transverse Myocutaneous Gracilis, Profunda Artery Perforator, and Fasciocutaneous Infragluteal Flaps: An Anatomical Study.

Plast Reconstr Surg 2019 Feb;143(2):381-390

Vienna, Pölten, and Linz, Austria From the Division of Anatomy and Cell Biology, Medical University of Vienna; the Department of Radiology, Kaiser-Franz-Josef Hospital; Plastic and Reconstructive Surgery, University of St. Pölten; the Section of Plastic and Reconstructive Surgery, Department of General Surgery, Kepler University Hospital; and maz, Microsurgical Training and Research Center.

Background: Perforator flaps of the upper thigh or buttock provide a valuable secondary choice in autologous breast reconstruction. The purpose of this study was to compare the vascular territories and supplying vessels of the transverse myocutaneous gracilis flap, the profunda artery perforator flap, and the fasciocutaneous infragluteal flap.

Methods: In total, 26 lower limbs from 13 fresh specimens were investigated. Read More

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http://dx.doi.org/10.1097/PRS.0000000000005276DOI Listing
February 2019

Optimizing DIEP Flap Insetting for Immediate Unilateral Breast Reconstruction: A Prospective Cohort Study of Patient-Reported Aesthetic Outcomes.

Plast Reconstr Surg 2019 Feb;143(2):261e-270e

Norwich and Leeds, United Kingdom; and Cagliari, Sardinia, Italy From the Department of Plastic and Reconstructive Surgery, Norfolk and Norwich University Hospital NHS Foundation Trust; the Department of Plastic and Reconstructive Surgery, Leeds Teaching Hospitals Trust; the Faculty of Medicine and Health Sciences, University of Leeds; and University of Cagliari, Department of Surgical Sciences, Plastic Surgery and Microsurgery Unit, University Hospital Duilio Casula.

Background: To improve the aesthetic outcome of deep inferior epigastric perforator (DIEP) flap breast reconstruction, flaps should be tailored to the patient's characteristics. A single method of DIEP flap insetting will not suffice for all women seeking breast reconstruction. The authors share the outcomes of a prospective longitudinal study on DIEP flap insetting and present an algorithm for reconstruction. Read More

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http://dx.doi.org/10.1097/PRS.0000000000005277DOI Listing
February 2019
4 Reads

Muscle-splitting approach to thoracoacromial vein for superdrainage in deep inferior epigastric artery perforator flap breast reconstruction.

Microsurgery 2019 Mar 21;39(3):228-233. Epub 2019 Jan 21.

Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

Background: Thoracoacromial vein (TAv) is seldomly considered as a secondary outflow recipient option when venous congestion of deep inferior epigastric artery perforator (DIEP) flap is encountered. The purpose of this study was to present a computed tomography (CT)-based anatomy and a method of approaching TAv in performing superdrainage using superficial inferior epigastric vein (SIEV) in DIEP flap breast reconstruction.

Methods: For CT-based anatomical study, 42 thoracoacromial vessels (TAV) of 21 patients who underwent DIEP flap breast reconstruction were analyzed. Read More

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http://dx.doi.org/10.1002/micr.30421DOI Listing
March 2019
2 Reads

Quality of life, patient satisfaction and cosmetic outcome after delayed breast reconstruction using DIEP flap: a 10 years' follow-up survey.

J Plast Surg Hand Surg 2019 Apr 18;53(2):119-124. Epub 2019 Jan 18.

a Department of Plastic and Reconstructive Surgery , Oslo University Hospital , Oslo , Norway.

Autologous breast reconstruction (BR) aims to restore body image and improve health-related quality of life in women undergoing mastectomy due to breast cancer. We wanted to explore patient-reported cosmetic results and satisfaction 10 or more years post BR surgery, using deep inferior epigastric perforator flap (DIEP). This is a follow-up study based on the same patient population of 34 patients undergoing delayed DIEP-flap procedure during 2001-2004 at Oslo University Hospital investigated by our group and published in 2008; Four patients died during the 10 years' follow-up time and four patients with total or partial flap failure were excluded. Read More

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http://dx.doi.org/10.1080/2000656X.2018.1562459DOI Listing
April 2019
3 Reads

[Application of dual-pedicle abdominal flap for unilateral breast reconstruction].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2019 Jan;33(1):70-74

Department of Plastic and Reconstructive Surgery, Peking University People's Hospital, Beijing, 100044, P.R.China.

Objective: To explore the effectiveness of dual-pedicle abdominal flap for unilateral breast reconstruction.

Methods: Between March 2014 and March 2018, a clinical data of 19 female patients underwent dual-pedicle abdominal flap reconstruction because of unilateral mastectomy defect was reviewed retrospectively. The median age was 45 years (range, 32-51 years), including 3 immediate breast reconstruction and 16 delayed breast reconstruction, and left side in 7 cases and right side in 12 cases. Read More

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http://www.rrsurg.com/article/10.7507/1002-1892.201807043
Publisher Site
http://dx.doi.org/10.7507/1002-1892.201807043DOI Listing
January 2019
13 Reads

Autologous Breast Reconstruction With a Delay Procedure of the Deep Inferior Epigastric Artery Perforator Flap Because of Venous Congestion of the Flap on Pedicle: A Case Series.

Ann Plast Surg 2019 Jan 9. Epub 2019 Jan 9.

Department of Plastic, Reconstructive & Hand Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands.

The deep inferior epigastric artery perforator (DIEP) flap is one of the most used free flaps for the reconstruction of the breast after a mastectomy. Despite careful selection of the patients and preoperative imaging, difficulties in vascularization of the flap can occur in some cases. Although multiple vascular connections (bipedicled, turbocharged, or stacked) can be made in selected cases, there can still be venous congestion before the flap is transferred. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001752DOI Listing
January 2019
3 Reads

The "Dual-Plane" DIEP Flap: Measuring the Effects of Superficial Arterial and Venous Flow Augmentation on Clinical Outcomes.

J Reconstr Microsurg 2019 Jan 7. Epub 2019 Jan 7.

Division of Plastic and Reconstructive Surgery, University of California San Francisco, San Francisco, California.

Background:  Deep inferior epigastric perforator (DIEP) flaps are routinely elevated on a single dominant perforator from the deep epigastric vascular system. However, the single perforator may not always perfuse an entire flap adequately, particularly suprascarpal tissue. We often perform "dual-plane" single perforator DIEP flaps by rerouting the superficial (SIEA/V) system directly into a branch of the deep (DIEA/V) vascular system pedicle, thus allowing both systems to contribute and enhance flap perfusion. Read More

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http://dx.doi.org/10.1055/s-0038-1677013DOI Listing
January 2019
2 Reads

[Postoperative course after immediate breast reconstruction: Comparison between five surgical techniques].

Ann Chir Plast Esthet 2019 Jan 2. Epub 2019 Jan 2.

Service de chirurgie plastique, hôpital civil Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France.

Introduction: This study analyzes postoperative course of different immediate breast reconstruction techniques: deep inferior epigastric perforator flap (DIEP), gracilis, latissimus dorsi flap, expander implants and definitive implants.

Methods: All women operated on IBR between 2012 and 2017 in the CHU Strasbourg were included in this retrospective study. The main data collected were healing time, complications, surgical revisions and failure rates. Read More

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http://dx.doi.org/10.1016/j.anplas.2018.12.001DOI Listing
January 2019
4 Reads

[Colgajo DIEP como primera opción de reconstrucción mamaria en pacientes mexicanas con cicatrices abdominales previas].

Cir Cir 2019 ;87(1):53-58

Departamento de Cirugía Plástica y Reconstructiva, Hospital de Traumatología y Ortopedia no. 21, Instituto Mexicano del Seguro Social (IMSS), Monterrey, Nuevo León, México.

Introduction: For many years the abdominal region has been a reliable donor of abundant well-perfused tissue. The subdermal plexus constitutes an intricate network of microvessels that comprise the entire abdominal skin and allow for innumerable and redundant connections.

Method: Using a retrospective cohort study, we considered the first 100 deep inferior epigastric perforator (DIEP) flaps performed for breast reconstruction in the High Specialty Medical Department #21 of the Mexican Institute of Social Security in Monterrey, Nuevo Leon, Mexico, from January 2010 until December 2015. Read More

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http://dx.doi.org/10.24875/CIRU.18000422DOI Listing
January 2019
1 Read

A cost-effectiveness analysis of DIEP vs free MS-TRAM flap for microsurgical breast reconstruction.

J Surg Oncol 2019 Mar 18;119(3):388-396. Epub 2018 Dec 18.

Division of Plastic and Reconstructive Surgery, University Health Network, Toronto, Ontario, Canada.

Background And Objectives: The deep inferior epigastric perforator (DIEP) flap may be associated with less long-term donor-site morbidity compared with free muscle-sparing transverse rectus abdominis myocutaneous flap (MS-TRAM) flap. However, DIEP flaps may have longer operative time and higher rates of acute postoperative complications. We performed a cost-effectiveness analysis (CEA) that compared the long-term costs and patient-reported outcomes between the two flaps. Read More

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http://dx.doi.org/10.1002/jso.25325DOI Listing
March 2019
3 Reads

Comparison of Polypropylene and Bioabsorbable Mesh for Abdominal Wall Reinforcement following Microsurgical Breast Reconstruction.

J Reconstr Microsurg 2018 Dec 17. Epub 2018 Dec 17.

Department of Plastic Surgery and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.

Background:  Abdominal wall morbidity following microvascular breast reconstruction continues to be an area of interest due to both functional and aesthetic concerns. Donor-site closure technique has been shown to affect bulge and hernia rates and ranges from primary closure to various uses of mesh. Few studies to date have compared types of mesh. Read More

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http://dx.doi.org/10.1055/s-0038-1676470DOI Listing
December 2018
7 Reads

The Medial Pillar Island Flap for Oncoplastic Breast Reconstruction of Upper Pole Defects.

Ann Plast Surg 2019 Apr;82(4):375-381

Surgical Oncology, Department of Surgery, University of Massachusetts Medical School, Worcester, MA.

Background: Breast deformity is common following lumpectomy. Use of ptotic lower pole tissue for restoration of volume in the upper pole is quite appealing since it allows for a concomitant lift. This study presents the medial pillar island flap technique of oncoplastic breast reconstruction of upper pole defects. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001673DOI Listing
April 2019
14 Reads

New Approach to Oncoplastic Breast Conservation: Combining Autologous Volume Replacement and the Wise-pattern Mammaplasty.

Plast Reconstr Surg Glob Open 2018 Oct 16;6(10):e1987. Epub 2018 Oct 16.

Georgia Breast Surgery, Lawrenceville, Ga.

Background: Oncoplastic breast-conserving surgery describes a set of techniques that allow for generous oncological resection with immediate tumor-specific reconstruction. These techniques are classically divided into either volume displacement (local breast flaps and or reduction mammaplasty/mastopexy strategies) versus volume replacement strategies (transfer of autologous nonbreast tissue from a local or distant site and, less commonly, implant placement). There have been few descriptions of merging these 2 classical approaches to facilitate breast-conserving surgery. Read More

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http://dx.doi.org/10.1097/GOX.0000000000001987DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6250486PMC
October 2018
5 Reads

In-Vivo Quantitative Mapping of the Perforasomes of Deep Inferior Epigastric Artery Perforators.

Plast Reconstr Surg Glob Open 2018 Oct 4;6(10):e1960. Epub 2018 Oct 4.

Department of Plastic, Reconstructive and Hand Surgery, Peninsula Health, Frankston, Victoria, Australia.

Background: There is limited understanding of anatomy of perforator angiosomes, or "perforasomes," of the deep inferior epigastric artery (DIEA). A perforasome is defined as the territory perfused by a single perforator vessel of a named artery, such as the DIEA. Given the clinical significance of this anatomical concept in microsurgical breast reconstruction, this study is a quantitative investigation of DIEA perforasome characteristics and patterns associated with perforasome size, perforator caliber, location and branching, using computed tomographic (CT) angiography. Read More

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http://Insights.ovid.com/crossref?an=01720096-201810000-0001
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http://dx.doi.org/10.1097/GOX.0000000000001960DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6250480PMC
October 2018
13 Reads

The effect of CT angiography and venous couplers on surgery duration in microvascular breast reconstruction: a single operator's experience.

Gland Surg 2018 Oct;7(5):440-448

Plastic & Reconstructive Surgery Department, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Background: The use of CT angiography (CTA) or venous couplers (VCs) has led to shorter operative times in free flap breast reconstruction (FFBR). However, there are no reports on the effect of these two interventions relative to each other or combined.

Methods: Abdominal based FFBRs performed by a single surgeon before introduction of either intervention were compared to those with VC only, and those after the addition of CTA to VCs (CT-VC). Read More

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http://dx.doi.org/10.21037/gs.2018.07.11DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6234237PMC
October 2018

Reply: Minimally Invasive Laparoscopically Dissected Deep Inferior Epigastric Artery Perforator Flap: An Anatomical Feasibility Study and a First Clinical Case.

Plast Reconstr Surg 2018 11;142(5):787e-789e

Service de Chirurgie Plastique, Reconstructrice, et Esthétique, Hôpital Européen Georges Pompidou, Clinique de L'Alma, Institut Français du Sein, Assistance Publique-Hôpitaux de Paris et Université Paris Descartes Clinique de L'Alma, Institut Français du Sein Service de Chirurgie Plastique, Reconstructrice, et Esthétique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris et Université Paris Descartes Service d'Oto-Rhino-Laryngologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris et Université Paris Descartes Service de Chirurgie Plastique, Reconstructrice et Esthétique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris et Université Paris Descartes, Paris, France.

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http://dx.doi.org/10.1097/PRS.0000000000004947DOI Listing
November 2018

Assessing Age as a Risk Factor for Complications in Autologous Breast Reconstruction.

Plast Reconstr Surg 2018 12;142(6):840e-846e

New Orleans, La. From the Division of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center.

Background: Breast cancer is primarily a diagnosis of older women. Many patients seeking breast reconstruction are elderly women (aged 65 years or older). However, many surgeons anecdotally believe that surgery in elderly patients is inherently dangerous, or at least prone to more complications. Read More

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http://dx.doi.org/10.1097/PRS.0000000000004990DOI Listing
December 2018
12 Reads

Discussion: The Stacked Hemiabdominal Extended Perforator Flap for Autologous Breast Reconstruction.

Plast Reconstr Surg 2018 12;142(6):1435-1436

Dallas, Texas From the Department of Plastic Surgery, University of Texas Southwestern.

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http://dx.doi.org/10.1097/PRS.0000000000005061DOI Listing
December 2018

Utilizing the Retrograde Descending Internal Mammary Vein in DIEP Flap Anastomosis.

Eplasty 2018 29;18:ic23. Epub 2018 Oct 29.

Division of Plastic Surgery, Department of Surgery, Morsani College of Medicine, University of South Florida, Tampa.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6232948PMC
October 2018
1 Read

The Deep Circumflex Iliac Artery Perforator Flap for Breast Reconstruction: Un lambeau perforateur de l'artère iliaque circonflexe profonde pour la reconstruction mammaire.

Plast Surg (Oakv) 2018 Nov 1;26(4):229-237. Epub 2018 Nov 1.

Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada.

Autologous breast reconstruction using abdominal-based perforator flaps produces excellent aesthetic results with minimal donor site morbidity. The superficial inferior epigastric artery and deep inferior epigastric perforator (DIEP) flaps reliably perfuse a hemi-abdomen, up to the anterior axillary line. Beyond this line laterally, the flank or "love handle" tissue is primarily perfused by the deep circumflex iliac artery (DCIA) or secondarily by the superficial circumflex iliac artery. Read More

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http://dx.doi.org/10.1177/2292550318800329DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6236510PMC
November 2018
4 Reads

Function and Strength after Free Abdominally Based Breast Reconstruction: A 10-Year Follow-Up.

Plast Reconstr Surg 2019 01;143(1):22e-31e

New York, N.Y.; Houston, Texas; and Philadelphia, Pa. From the Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center; the Department of Plastic Surgery, M. D. Anderson Cancer Center; and the Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania.

Background: The long-term impact of abdominally based free flap breast reconstruction is incompletely understood. The aim of this study is to provide long-term, subjective and objective health data on abdominally based free flap breast reconstruction patients, with specific attention to the effects of laterality, flap type, and obesity.

Methods: Patients were enrolled in this prospective study between 2005 and 2010 and completed preoperative, early (<1 year), and long-term (5 to 10 years) evaluations. Read More

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http://dx.doi.org/10.1097/PRS.0000000000005096DOI Listing
January 2019
1 Read

Nipple-sparing Mastectomy and Immediate Breast Reconstruction After Recurrence From Previous Breast Conservation Therapy.

Ann Plast Surg 2019 Jan;82(1S Suppl 1):S95-S102

Purpose: Breast conservation therapy (BCT) is widely accepted for breast cancer treatment. Nipple-sparing mastectomy has been newly developed to preserve the nipple-areolar complex and enhance aesthetic results. The purpose of this study was to evaluate the oncological safety and results of nipple-sparing mastectomy (NSM) after previous BCT. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001696DOI Listing
January 2019

Chyle Leak Following Autologous Breast Reconstruction: A Rare Complication of a Deep Inferior Epigastric Artery Perforator Flap.

Ann Plast Surg 2019 Feb;82(2):193-195

Department of Plastic Surgery, University of Kansas Health System, Kansas City, KS.

Background: While complications of deep inferior epigastric artery perforator flaps are known and well documented, a thorough literature review revealed no other reports of a patient developing a chyle leak following the use of the internal mammary vessels for recipient vessels in autologous breast reconstruction.

Case: A 55-year-old woman underwent free autologous breast reconstruction. She developed a chyle leak during the postoperative period. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001639DOI Listing
February 2019
13 Reads

Distribution of internal thoracic artery perforators: A clincal anatomy study.

Clin Anat 2018 Nov 13. Epub 2018 Nov 13.

Department of Plastic and Reconstructive Surgery, Bundang CHA Medical Center, School of Medicine, CHA University, Seongnam, South Korea.

There are various modifications of the transverse rectus abdominis musculocutaneous flap and deep inferior epigastric perforator flap to reduce the morbidity of the donor site or to augment the vascularity of the flap. For microanastomosis of multiple pedicles, multiple recipient vessels or an intervening vein graft should be provided. In addition, alternative perforator-based flaps used in breast reconstruction have small caliber pedicles. Read More

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http://doi.wiley.com/10.1002/ca.23312
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http://dx.doi.org/10.1002/ca.23312DOI Listing
November 2018
10 Reads

Reply: The Lateral Thigh Perforator Flap for Autologous Breast Reconstruction: A Prospective Analysis of 138 Flaps.

Plast Reconstr Surg 2019 01;143(1):249e-250e

P. Debeyelaan 25, 6229 HX Maastricht, The Netherlands,

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http://dx.doi.org/10.1097/PRS.0000000000005155DOI Listing
January 2019

The Lateral Thigh Perforator Propeller Flap: A Reliable Backup Plan for Locoregional Reconstruction in Case of Missing or Unreliable Anterolateral Thigh Perforators.

Plast Reconstr Surg 2019 01;143(1):248e-249e

Plastic, Reconstructive and Aesthetic Surgery Department, Campus Bio-Medico University, Rome, Italy.

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http://dx.doi.org/10.1097/PRS.0000000000005154DOI Listing
January 2019

Effect of breast reconstruction modality on the development of postmastectomy shoulder morbidity.

J Plast Reconstr Aesthet Surg 2018 Dec 6;71(12):1761-1767. Epub 2018 Aug 6.

Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, Korea. Electronic address:

Background: The aim of this study was to evaluate the impact of breast reconstruction modality on the incidence of shoulder morbidity.

Methods: Breast cancer patients who underwent immediate reconstructions using three modalities, namely, tissue expander-implant, latissimus dorsi (LD) pedicled flap, and deep inferior epigastric artery perforator (DIEP) flap, from 2008 to 2013 were examined. The cumulative incidence of shoulder morbidity was compared among the reconstruction modalities, and risk factor analysis was performed using multivariable analysis. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S17486815183027
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http://dx.doi.org/10.1016/j.bjps.2018.07.033DOI Listing
December 2018
10 Reads