We present a case of breast cancer in the massive weight loss patient. In the light of the PIP implant scandal, the patient demanded an autologous reconstructive solution. We describe our surgical approach towards this unique problem and share our experience of performing a DIEP reconstruction using a fleur-de-lis pattern.
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http://dx.doi.org/10.1016/j.bjps.2013.01.003 | DOI Listing |
Microsurgery
January 2025
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.
Background: The deep inferior epigastric perforator (DIEP) flap is currently the gold standard for autologous breast reconstruction. In cases where the DIEP is contraindicated, the profunda artery perforator (PAP) flap is now the preferred second-line option in our institution. The PAP flap poses unique challenges to the reconstructive surgeon, especially in Asian women with low body mass index (BMI).
View Article and Find Full Text PDFJ Plast Reconstr Aesthet Surg
November 2024
Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université de Paris, Paris, France.
Background: Profunda artery perforator (PAP) flap following cancer surgery has emerged as a relevant alternative for breast reconstruction but is mainly used in cases where the deep inferior epigastric perforator (DIEP) flap cannot be performed. The aim of this study was to compare the PAP and DIEP flaps' surgical and aesthetics outcomes in breast reconstruction.
Methods: Women who underwent breast reconstruction by DIEP or PAP flap at the Plastic Surgery Department of Georges Pompidou European University Hospital, Paris, France, between January 2012 and December 2020 were included.
J Surg Oncol
December 2024
Section of Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Background: Patients with or at risk for breast cancer may opt for risk-reducing gynecologic surgeries, including bilateral salpingo-oophorectomies and/or total abdominal hysterectomy. The timing and safety of combining these procedures with autologous breast reconstruction (ABR) are debated. This study assesses the impact of concurrent ABR and gynecologic surgeries on clinical and patient-reported outcomes.
View Article and Find Full Text PDFPlast Reconstr Surg
December 2024
Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
Background: Enhanced Recovery After Surgery (ERAS) protocols can reduce the length of stay (LOS) for surgical patients, including those undergoing unilateral deep inferior epigastric artery perforator (DIEP) flap breast reconstruction, allowing most patients to be discharged by postoperative day 2. However, some patients require a prolonged inpatient stay due to difficulty completing postoperative milestones. This study aims to identify factors associated with increased LOS after DIEP flap breast reconstruction and assess safety of earlier discharge.
View Article and Find Full Text PDFJ Surg Oncol
December 2024
Department of Surgery, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
Introduction: This study aimed to develop and validate an aesthetic grading tool (AGT) for bilateral DIEP flap breast reconstruction and investigate the correlation of BREAST-Q scores with perceived aesthetic outcomes.
Methods: The AGT utilized a Likert scale to rate aesthetic outcomes based on photographs of post-reconstruction breasts. The validation involved iterative testing with healthcare providers and patients.
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