10-Year Experience of Hybrid DIEP with Implant Breast Reconstruction: Univariate Analyses of Risk Factors Associated with Flap Failure.

Document Type

Article

Publication Date

3-13-2026

Publication Title

Plastic and reconstructive surgery

Abstract

BACKGROUND: The combination of deep inferior epigastric artery perforator (DIEP) free flap and implant has been reported as a safe option for breast reconstruction in patients with insufficient abdominal donor tissue. We present a single-surgeon 10-year experience with hybrid reconstruction.

METHODS: We performed a retrospective review of patients who underwent hybrid breast reconstruction with DIEP and implant by a single surgeon at a single institution between 2014-2024. Patient characteristics and operative factors were analyzed for association with flap failure.

RESULTS: 91 patients (153 breasts) were included. Success rate following initial (simultaneous or delayed) implantation and after implant exchange were 98% and 96.1%, respectively. Univariate analyses showed significantly larger mean final implant size in the failed DIEP group (362.50±228.05 mL) compared to the successful reconstruction group (219.20±101.24 mL), with OR of 1.42 (95% CI: 1.149-1.76, p-value = 0.002) per 50 mL increase of the implant size.

CONCLUSIONS: Hybrid DIEP with implant reconstruction is a safe procedure. Placement of a greater volume implant is associated with flap failure. Implant exchange for upsize also possesses a risk of flap failure.

DOI

10.1097/PRS.0000000000013029

ISSN

1529-4242

PubMed ID

41825067

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