<< Back to the abstract archive
Staged Augmentation After Abdominal Free Flap Breast Reconstruction.
M Asher Schusterman II, Vu T. Nguyen
University of Pittsburgh Medical Center
2015-03-15
Presenter: M. Asher Schusterman II
Affidavit:
This is the original work of the resident.
Director Name: Joseph Losee
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background: Traditionally, latissimus dorsi muscle flap and tissue expander (LD/TE) has been utilized in women with little native abdominal tissue who are at increased risk of implant exposure. Another option is implant augmentation after abdominal free flap reconstruction. In this study we describe our series using this technique and compare outcomes to LD/TE.
Methods: Retrospective chart review was performed on all patients who underwent breast reconstruction with abdominal free flap and subsequent augmentation using permanent implant. Data points included patient demographics, comorbidities, surgical details, complications, and follow-up. Data was compared to historical controls reported in published articles that were most commonly cited studying LD/TE.
Results: A total of 7 patients underwent bilateral reconstruction of 14 breasts with subsequent implant placement. Average age was 40 years and average BMI was 24.0. Average time between initial reconstruction and implant placement was 8.95 months (range 6.5-14 months) and mean follow-up time was 21 months after implant placement (range 4.5-46 months). Incidence of any breast complication was 35.7% (n=5). Overall donor site complication rate was 33.3% (n=4). The most common breast complication was wound infection/dehiscence and the most common abdominal complication was abdominal bulge/hernia. The most common reported complication of LD/TE is donor site seroma, with rates ranging from 33-79%.
Conclusion: Staged augmentation after free flap breast reconstruction produces desirable results with similar donor and recipient site complication rates compared to LD/TE. Also, the free flap patient is not required to undergo serial expansion prior to implant placement.
