Immediate breast reconstruction with a ‘modified fleur-de-lis’ abdominal-free flap in a patient with previous abdominal surgery

DIEP flap has become the gold standard method for patients undergoing autologous breast reconstruction; however, previous surgery or scars in the abdominal area have been considered a relative contraindication for the use of abdominal tissue. Longitudinal midline abdominal scars may be specially pro...

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Main Authors: Manuel Robustillo, Luis Parra Pont, Georgios Pafitanis, Pedro Ciudad, Daniel Grandes, Israel Iglesias
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2018-01-01
Series:Indian Journal of Plastic Surgery
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.4103/ijps.IJPS_185_17
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author Manuel Robustillo
Luis Parra Pont
Georgios Pafitanis
Pedro Ciudad
Daniel Grandes
Israel Iglesias
author_facet Manuel Robustillo
Luis Parra Pont
Georgios Pafitanis
Pedro Ciudad
Daniel Grandes
Israel Iglesias
author_sort Manuel Robustillo
collection DOAJ
description DIEP flap has become the gold standard method for patients undergoing autologous breast reconstruction; however, previous surgery or scars in the abdominal area have been considered a relative contraindication for the use of abdominal tissue. Longitudinal midline abdominal scars may be specially problematic because of the poor midline crossover of blood and the high risk of necrosis of the distal flap. Patients with small breast may be easily reconstructed with hemi-DIEP flap; however, patients with large breast need more tissue available. Our aim is to report a modification of a ‘fleur-de-lis pattern’ for a breast reconstruction in a patient with previous abdominal surgery and large breast. The post-operative course was uneventful, flap did not show blood supply compromise, volume and symmetry are preserved after 6 months post-operative and donor site morbidity has not been observed. This modification may be very useful to avoid complications related to poor blood supply associated with scar tissues. Careful pre-operative planning and the transfer of only well-vascularised tissue are essential for a successful reconstruction.
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publishDate 2018-01-01
publisher Thieme Medical and Scientific Publishers Pvt. Ltd.
record_format Article
series Indian Journal of Plastic Surgery
spelling doaj-art-eabb0eabd2ca4b81813361bcbf9a1a182025-08-20T03:20:39ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2018-01-01510108909210.4103/ijps.IJPS_185_17Immediate breast reconstruction with a ‘modified fleur-de-lis’ abdominal-free flap in a patient with previous abdominal surgeryManuel Robustillo0Luis Parra Pont1Georgios Pafitanis2Pedro Ciudad3Daniel Grandes4Israel Iglesias5Department of Plastic and Reconstructive Surgery, Hospital 12 de Octubre, Madrid, SpainDepartment of Plastic and Reconstructive Surgery, Hospital 12 de Octubre, Madrid, SpainDepartment of Plastic and Reconstructive Surgery Queen Mary University of London, The Royal London Hospital, Barts Health NHS Trust, London, United KingdomDepartment of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, TaiwanDepartment of Plastic and Reconstructive Surgery, Hospital 12 de Octubre, Madrid, SpainDepartment of Plastic and Reconstructive Surgery, Hospital 12 de Octubre, Madrid, SpainDIEP flap has become the gold standard method for patients undergoing autologous breast reconstruction; however, previous surgery or scars in the abdominal area have been considered a relative contraindication for the use of abdominal tissue. Longitudinal midline abdominal scars may be specially problematic because of the poor midline crossover of blood and the high risk of necrosis of the distal flap. Patients with small breast may be easily reconstructed with hemi-DIEP flap; however, patients with large breast need more tissue available. Our aim is to report a modification of a ‘fleur-de-lis pattern’ for a breast reconstruction in a patient with previous abdominal surgery and large breast. The post-operative course was uneventful, flap did not show blood supply compromise, volume and symmetry are preserved after 6 months post-operative and donor site morbidity has not been observed. This modification may be very useful to avoid complications related to poor blood supply associated with scar tissues. Careful pre-operative planning and the transfer of only well-vascularised tissue are essential for a successful reconstruction.http://www.thieme-connect.de/DOI/DOI?10.4103/ijps.IJPS_185_17abdominal scarsbreast reconstructionfleur-de-lismodified diep
spellingShingle Manuel Robustillo
Luis Parra Pont
Georgios Pafitanis
Pedro Ciudad
Daniel Grandes
Israel Iglesias
Immediate breast reconstruction with a ‘modified fleur-de-lis’ abdominal-free flap in a patient with previous abdominal surgery
Indian Journal of Plastic Surgery
abdominal scars
breast reconstruction
fleur-de-lis
modified diep
title Immediate breast reconstruction with a ‘modified fleur-de-lis’ abdominal-free flap in a patient with previous abdominal surgery
title_full Immediate breast reconstruction with a ‘modified fleur-de-lis’ abdominal-free flap in a patient with previous abdominal surgery
title_fullStr Immediate breast reconstruction with a ‘modified fleur-de-lis’ abdominal-free flap in a patient with previous abdominal surgery
title_full_unstemmed Immediate breast reconstruction with a ‘modified fleur-de-lis’ abdominal-free flap in a patient with previous abdominal surgery
title_short Immediate breast reconstruction with a ‘modified fleur-de-lis’ abdominal-free flap in a patient with previous abdominal surgery
title_sort immediate breast reconstruction with a modified fleur de lis abdominal free flap in a patient with previous abdominal surgery
topic abdominal scars
breast reconstruction
fleur-de-lis
modified diep
url http://www.thieme-connect.de/DOI/DOI?10.4103/ijps.IJPS_185_17
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