One-stage DIEP flap breast reconstruction: Algorithm for immediate contralateral symmetrization.
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.
Plastic Surgery Department, Sant'andrea Hospital, School of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy.
Rosaria
R
Laporta
Plastic Surgery Department, Sant'andrea Hospital, School of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy.
Benedetto
B
Longo
Plastic Surgery Department, Sant'andrea Hospital, School of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy.
Michail
M
Sorotos
Plastic Surgery Department, Sant'andrea Hospital, School of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy.
Marco
M
Pagnoni
Plastic Surgery Department, Sant'andrea Hospital, School of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy.
Fabio
F
Santanelli Di Pompeo
D000328:Adult; D000368:Aged; D000465:Algorithms; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D061525:Perforator Flap; D012189:Retrospective Studies; D013997:Time Factors