title: Low-rise scar deep inferior epigastric artery perforator flap for breast reconstruction.
abstract: BACKGROUND
  To achieve an unnoticeable postoperative scar in patients with little abdominal skin laxity for breast reconstruction by deep inferior epigastric artery perforator (DIEP) flap, we devised a new design called the low-rise scar DIEP flap; the skin paddle of this flap is located lower with a smaller vertical width, and more adipose tissue is elevated to obtain enough volume. The purpose of this report is to evaluate the utility of the low-rise scar DIEP flap compared with that of the conventionally designed flap.
  
  
  METHODS
  Twelve patients who underwent low-rise scar DIEP flaps (study group) and 11 patients who underwent conventionally-designed DIEP flaps (control group) were included in the present study. The distance from the umbilicus to horizontal scar was divided by the patient's height. The length of the scar was divided by the abdominal circumference. These ratios were compared between groups.
  
  
  RESULTS
  All flaps survived completely and no recipient site complication was observed, except for one case in the control group with small-range fat necrosis. No donor site complication was observed in either group. The distance ratio was significantly larger in study group (<0.01, 0.049 ± 0.004, and 0.028 ± 0.005, respectively). The length ratio was significantly smaller in the study group <0.01, 0.42 ± 0.02 and 0.36 ± 0.02, respectively). The weight of the flap used for reconstruction was 338.8 ± 127.7 g in the study group and 320.5 ± 63.0 g in the control group
  
  
  CONCLUSIONS
  A low-rise scar DIEP flap leaves a lower and shorter postoperative scar.
authors.affiliation: Department of Plastic, Reconstructive, and Aesthetic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Akita
authors.affiliation: Department of Plastic, Reconstructive, and Aesthetic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Mitsukawa
authors.affiliation: Division of Plastic and Reconstructive Surgery, Chiba Cancer Center, Chiba, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Tokumoto
authors.affiliation: Department of Plastic and Reconstructive Surgery, Kochi Medical School Hospital, Nankoku, Japan.
authors.forename: Motone
authors.initials: M
authors.lastname: Kuriyama
authors.affiliation: Department of Plastic, Reconstructive, and Aesthetic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Kubota
authors.affiliation: Department of Plastic, Reconstructive, and Aesthetic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Tomoe
authors.initials: T
authors.lastname: Kira
authors.affiliation: Department of Plastic, Reconstructive, and Aesthetic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Yoshitaro
authors.initials: Y
authors.lastname: Sasahara
authors.affiliation: Department of General Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sakakibara
authors.affiliation: Department of General Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagashima
authors.affiliation: Department of Plastic, Reconstructive, and Aesthetic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Kaneshige
authors.initials: K
authors.lastname: Satoh
mesh_terms: D000328:Adult; D002921:Cicatrix / Q000209:etiology / Q000517:prevention & control*; D019074:Epigastric Arteries; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D061525:Perforator Flap / Q000098:blood supply; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies