The free deep inferior epigastric artery perforator (DIEP) flap is the gold standard in autologous breast reconstruction. Asian patients often present with a smaller body mass index with relatively insufficient tissue. To restore appropriate symmetry, a larger flap inset ratio must be transferred. Supercharging of the second vein or inclusion of bilateral pedicle is commonly required. Current paradigm shifts in mastectomy has also resulted in more minimally invasive surgeries (MIS) espousing smaller lateral incisions, leading to a significant change in available recipient vessels. This study aimed to demonstrate our experience in changing strategies of DIEP flaps following the evolution of mastectomy techniques. Between October 2008 and March 2022, retrospective data was gathered for 278 patients who underwent breast reconstruction surgery utilizing DIEP flaps by a single plastic surgeon. These patients were divided into two distinct groups based on their operation dates, with November 2018 marking a pivotal moment when the first MIS was introduced.
Study Type
OBSERVATIONAL
Enrollment
278
November 2018 as a temporal reference point was predicated on the milestone of the medical center's inaugural minimally invasive mastectomy procedure conducted
Chang Gung Memorial Hospital
Taoyuan District, Taiwan
Endoscopy mastectomy
Time frame: Post-operative day 0
Robotic mastectomy
Time frame: Post-operative day 0
Incision
Time frame: Post-operative day 0
Usage of SIEV
Time frame: Post-operative day 0
Inclusion of bipedicle
Time frame: Post-operative day 0
Location of recipient artery/vein
Time frame: Post-operative day 0
Recipient artery/vein selection
Time frame: Post-operative day 0
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