Aesthetic Breast Reconstruction With De-epidermized Deep Inferior Epigastric Artery Perforator Flap and Thoracoabdominal Advancement Flap

Background:. Most regard the deep inferior epigastric artery perforator (DIEP) flap as the gold standard in autologous breast reconstruction, with good breast aesthetics achieved and low donor site morbidity. Mojallal et al introduced a new surgical protocol to enhance results for both the breast an...

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Main Authors: Haïzam Oubari, MD, MSc, Fabien Boucher, MD, Abdulrahman Hashim, MD, Franck Dupuy, MD, Hristo Shipkov, MD, PhD, Ali Mojallal, MD, PhD
Format: Article
Language:English
Published: Wolters Kluwer 2025-08-01
Series:Plastic and Reconstructive Surgery, Global Open
Online Access:http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006985
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author Haïzam Oubari, MD, MSc
Fabien Boucher, MD
Abdulrahman Hashim, MD
Franck Dupuy, MD
Hristo Shipkov, MD, PhD
Ali Mojallal, MD, PhD
author_facet Haïzam Oubari, MD, MSc
Fabien Boucher, MD
Abdulrahman Hashim, MD
Franck Dupuy, MD
Hristo Shipkov, MD, PhD
Ali Mojallal, MD, PhD
author_sort Haïzam Oubari, MD, MSc
collection DOAJ
description Background:. Most regard the deep inferior epigastric artery perforator (DIEP) flap as the gold standard in autologous breast reconstruction, with good breast aesthetics achieved and low donor site morbidity. Mojallal et al introduced a new surgical protocol to enhance results for both the breast and abdomen further. This study presented the first clinical series of patients benefitting from breast reconstruction based on a combination of a DIEP flap and a thoracoabdominal advancement flap (TAAF). Methods:. A retrospective study was conducted at our institution from January 2013 to October 2020. We included all 100 consecutive patients in whom the technique was used. Patients’ characteristics, types of surgical procedures, and outcomes were recorded. Patient satisfaction and quality of life were measured with BREAST-Q 2.0 reconstructive modules. Results:. A total of 101 DIEP flaps and 100 TAAFs were included. The mean follow-up was 26.9 months. In all cases, the DIEP skin paddle could be removed, and the abdominal scar was concealed under the patient’s undergarments. No TAAF necrosis or major abdominal complications were recorded. Four DIEP flap failures were successfully treated with implants, lipofilling, or muscle-sparing latissimus dorsi flaps while preserving the benefit of the TAAF. Breast and abdominal aesthetics were satisfying, with high BREAST-Q scores. Conclusions:. The TAAF combined with the DIEP flap is a reliable technique for delayed unilateral breast reconstruction. Excellent aesthetic results and high patient satisfaction can be achieved without compromising safety.
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spelling doaj-art-f155e7ca81e9477b95b19a35bb00bb322025-08-26T03:24:29ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742025-08-01138e698510.1097/GOX.0000000000006985202508000-00001Aesthetic Breast Reconstruction With De-epidermized Deep Inferior Epigastric Artery Perforator Flap and Thoracoabdominal Advancement FlapHaïzam Oubari, MD, MSc0Fabien Boucher, MD1Abdulrahman Hashim, MD2Franck Dupuy, MD3Hristo Shipkov, MD, PhD4Ali Mojallal, MD, PhD5From the Department of Plastic and Reconstructive Surgery, Croix-Rousse Hospital, University Hospital of Lyon, Lyon, France.From the Department of Plastic and Reconstructive Surgery, Croix-Rousse Hospital, University Hospital of Lyon, Lyon, France.From the Department of Plastic and Reconstructive Surgery, Croix-Rousse Hospital, University Hospital of Lyon, Lyon, France.From the Department of Plastic and Reconstructive Surgery, Croix-Rousse Hospital, University Hospital of Lyon, Lyon, France.From the Department of Plastic and Reconstructive Surgery, Croix-Rousse Hospital, University Hospital of Lyon, Lyon, France.From the Department of Plastic and Reconstructive Surgery, Croix-Rousse Hospital, University Hospital of Lyon, Lyon, France.Background:. Most regard the deep inferior epigastric artery perforator (DIEP) flap as the gold standard in autologous breast reconstruction, with good breast aesthetics achieved and low donor site morbidity. Mojallal et al introduced a new surgical protocol to enhance results for both the breast and abdomen further. This study presented the first clinical series of patients benefitting from breast reconstruction based on a combination of a DIEP flap and a thoracoabdominal advancement flap (TAAF). Methods:. A retrospective study was conducted at our institution from January 2013 to October 2020. We included all 100 consecutive patients in whom the technique was used. Patients’ characteristics, types of surgical procedures, and outcomes were recorded. Patient satisfaction and quality of life were measured with BREAST-Q 2.0 reconstructive modules. Results:. A total of 101 DIEP flaps and 100 TAAFs were included. The mean follow-up was 26.9 months. In all cases, the DIEP skin paddle could be removed, and the abdominal scar was concealed under the patient’s undergarments. No TAAF necrosis or major abdominal complications were recorded. Four DIEP flap failures were successfully treated with implants, lipofilling, or muscle-sparing latissimus dorsi flaps while preserving the benefit of the TAAF. Breast and abdominal aesthetics were satisfying, with high BREAST-Q scores. Conclusions:. The TAAF combined with the DIEP flap is a reliable technique for delayed unilateral breast reconstruction. Excellent aesthetic results and high patient satisfaction can be achieved without compromising safety.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006985
spellingShingle Haïzam Oubari, MD, MSc
Fabien Boucher, MD
Abdulrahman Hashim, MD
Franck Dupuy, MD
Hristo Shipkov, MD, PhD
Ali Mojallal, MD, PhD
Aesthetic Breast Reconstruction With De-epidermized Deep Inferior Epigastric Artery Perforator Flap and Thoracoabdominal Advancement Flap
Plastic and Reconstructive Surgery, Global Open
title Aesthetic Breast Reconstruction With De-epidermized Deep Inferior Epigastric Artery Perforator Flap and Thoracoabdominal Advancement Flap
title_full Aesthetic Breast Reconstruction With De-epidermized Deep Inferior Epigastric Artery Perforator Flap and Thoracoabdominal Advancement Flap
title_fullStr Aesthetic Breast Reconstruction With De-epidermized Deep Inferior Epigastric Artery Perforator Flap and Thoracoabdominal Advancement Flap
title_full_unstemmed Aesthetic Breast Reconstruction With De-epidermized Deep Inferior Epigastric Artery Perforator Flap and Thoracoabdominal Advancement Flap
title_short Aesthetic Breast Reconstruction With De-epidermized Deep Inferior Epigastric Artery Perforator Flap and Thoracoabdominal Advancement Flap
title_sort aesthetic breast reconstruction with de epidermized deep inferior epigastric artery perforator flap and thoracoabdominal advancement flap
url http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006985
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