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Description

The deep inferior epigastric perforator (DIEP) flap has remained the gold standard for perforator flap reconstruction due to its consistent anatomy and low morbidity. Despite higher longterm patient satisfaction in autologous breast reconstruction compared to breast implants,1–3 implant-based reconstruction remains more common due to shorter operative time.

Several studies have examined the issue of optimizing efficiency of autologous breast reconstruction but were typically performed in the context of immediate reconstruction. In our institution and others, however, two-stage delayed reconstruction is the norm — a tissue expander is placed at the first stage for preservation of the skin envelope; after expansion and any adjuvant therapies are completed, the expanders are removed and replaced with DIEP flaps in a second stage.

The primary objective of this study was to compare the plastic surgeon’s operative time between DIEP flap reconstruction immediately following mastectomy (single-stage), versus immediate placement of tissue expander(s) followed by delayed DIEP flap reconstruction (two-stage). Secondary objectives included comparing total patient time under anesthesia and overall complications. We hypothesized that the operative time for the plastic surgeon to place tissue expanders and then return at a later date to perform free flap reconstruction would be the same or less than the time required for immediate flap reconstruction at the time of mastectomy.

Publication Date

5-2024

Disciplines

Plastic Surgery | Surgery

Comments

The Embark Capstone Colloquium at the Oakland University William Beaumont School of Medicine, Rochester Hills, MI, May, 2024.

Comparing Plastic Surgeon Operative Time for Deep Inferior Epigastric Perforator (DIEP) Flap Breast Reconstruction

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