title: Bilateral simultaneous breast reconstruction with transverse musculocutaneous gracilis flaps.
abstract: BACKGROUND
  A transverse musculocutaneous gracilis flap provides good autologous reconstruction for small- and medium-sized breasts. Although the procedure is well adapted for bilateral breast reconstruction, no publication has specifically addressed simultaneous bilateral cases.
  
  
  METHODS
  From 2010 to 2014, the authors performed seven simultaneous bilateral breast reconstructions using transverse musculocutaneous gracilis flaps. The results with respect to operative data, immediate complications, second-stage reconstruction, and patient satisfaction after >1 year of follow-up were studied retrospectively.
  
  
  RESULTS
  The mean operative time was 7 h and 48 min (range, 6-9 h). Three minor complications occurred: two cases of limited flap necrosis and one case of donor-site wound dehiscence. Surgical revision was not required, and there was no flap failure. A second-stage operation was performed in 71% of the patients to improve the aesthetic results and flap volume. On average, 167 cm(3) of fat was injected per breast. After a mean follow-up of 27 months, the satisfaction rate was 86% without significant functional deficits.
  
  
  CONCLUSIONS
  A transverse musculocutaneous gracilis flap is an effective and safe option for simultaneous bilateral reconstruction. The operating time is shorter than that for other autologous procedures with similar complication rates and high patient satisfaction levels.
authors.affiliation: Department of Plastic Surgery, Strasbourg Academic Hospital, Strasbourg, France. Electronic address: frederic.bodin@chru-strasbourg.fr.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Bodin
authors.affiliation: Department of Plastic Surgery, Strasbourg Academic Hospital, Strasbourg, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Schohn
authors.affiliation: Department of Plastic Surgery, Strasbourg Academic Hospital, Strasbourg, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Dissaux
authors.affiliation: Department of Plastic Surgery, Strasbourg Academic Hospital, Strasbourg, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Baratte
authors.affiliation: Department of Plastic Surgery, Strasbourg Academic Hospital, Strasbourg, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Fiquet
authors.affiliation: Department of Plastic Surgery, Strasbourg Academic Hospital, Strasbourg, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Bruant-Rodier
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D015414:Mastectomy, Subcutaneous / Q000379:methods*; D008875:Middle Aged; D064827:Myocutaneous Flap / Q000098:blood supply / Q000637:transplantation*; D061646:Operative Time; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
keywords: Bilateral breast reconstruction; Microsurgery; Prophylactic mastectomy; Transverse musculocutaneous gracilis (TMG) flap; Transverse upper gracilis (TUG) flap