title: Tips and Outcomes of a New DIEP Flap Inset in Delayed Breast Reconstruction: The Dual-Plane Technique.
abstract: Purpose The dual-plane deep inferior epigastric perforator (DIEP) flap inset technique is herein presented with tips for optimizing the aesthetic outcome in delayed autologous breast reconstruction after radiation therapy. Patients and Methods A total of 42 women who underwent microsurgical reconstruction with a free DIEP flap participated in this prospective study. The flap was inset in a dual plane lying behind the pectoralis major at the upper pole and in front of the muscle at the lower pole of the reconstructed breast. Results The dual-plane flap inset resulted in natural transition from native and reconstructed tissues, excellent scar quality, optimal outline of the breast, and overall breast appearance. Moreover, dual-plane reconstruction was associated with constantly high patient satisfaction without wearing brassiere due to fullness of the upper pole and minimal ptosis with time. Conclusion The dual-plane DIEP flap inset results in optimal scar quality, breast shape, and fullness of the upper pole, resulting in high patient satisfaction.
authors.affiliation: Department of Plastic Surgery, Microsurgery and Burn Center "J. Ioannovich," General State Hospital of Athens "G. Gennimatas," Athens, Greece.
authors.forename: Andreas
authors.initials: A
authors.lastname: Gravvanis
authors.affiliation: Department of Plastic Surgery, Microsurgery and Burn Center "J. Ioannovich," General State Hospital of Athens "G. Gennimatas," Athens, Greece.
authors.forename: Despoina
authors.initials: D
authors.lastname: Kakagia
authors.affiliation: Department of Plastic Surgery, Microsurgery and Burn Center "J. Ioannovich," General State Hospital of Athens "G. Gennimatas," Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Samouris
authors.affiliation: Department of Plastic Surgery, Microsurgery and Burn Center "J. Ioannovich," General State Hospital of Athens "G. Gennimatas," Athens, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Galani
authors.affiliation: Department of Plastic Surgery, Microsurgery and Burn Center "J. Ioannovich," General State Hospital of Athens "G. Gennimatas," Athens, Greece.
authors.forename: Dimosthenis
authors.initials: D
authors.lastname: Tsoutsos
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D019074:Epigastric Arteries / Q000637:transplantation*; D004954:Esthetics / Q000523:psychology; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply*; D006801:Humans; D016462:Mammaplasty / Q000379:methods* / Q000523:psychology; D008866:Microsurgery; D008875:Middle Aged; D017060:Patient Satisfaction; D061525:Perforator Flap / Q000098:blood supply*; D011446:Prospective Studies; D016896:Treatment Outcome