The Lipo-DIEP Flap Breast Reconstruction: A Valuable Innovation for Maximizing Abdominal Tissue Volume
Background:. The deep inferior epigastric perforator (DIEP) flap is universally considered the gold standard technique for breast reconstruction (BR), though it cannot always be proposed to patients with insufficient donor-site volume. We explore the efficacy of autologous fat transfer (AFT) of the...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2025-01-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006445 |
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| author | Benedetto Longo, MD, PhD Gennaro D’Orsi, MD Alessio Farcomeni, PhD Martina Giacalone, MD Elettra Gagliano Lisa Vannucchi, MD Maximilian Catenacci, MD Gianluca Vanni, MD Claudio Oreste Buonomo, MD Valerio Cervelli, MD |
| author_facet | Benedetto Longo, MD, PhD Gennaro D’Orsi, MD Alessio Farcomeni, PhD Martina Giacalone, MD Elettra Gagliano Lisa Vannucchi, MD Maximilian Catenacci, MD Gianluca Vanni, MD Claudio Oreste Buonomo, MD Valerio Cervelli, MD |
| author_sort | Benedetto Longo, MD, PhD |
| collection | DOAJ |
| description | Background:. The deep inferior epigastric perforator (DIEP) flap is universally considered the gold standard technique for breast reconstruction (BR), though it cannot always be proposed to patients with insufficient donor-site volume. We explore the efficacy of autologous fat transfer (AFT) of the Holm abdomen zone IV in the retropectoral plane during DIEP flap reconstruction (lipo-DIEP flap), to enhance the volume provided by the abdominal donor site in patients with low body mass index (BMI).
Methods:. We prospectively enrolled patients with BMI less than 25 kg/m2 and candidates for lipo-DIEP flap BR (group A) comparing them with a control group (group B) undergoing traditional DIEP flap BR with the same characteristics of the first group (BMI < 25 kg/m2). Patients belonging to group A underwent magnetic resonance imaging preoperatively and 6 months after the BR, evaluating the adipose tissue volume retained in the retropectoral space.
Results:. A total of 40 breasts were included in the study. The 2 groups were homogeneous regarding the collected variables, except for mean delayed AFT sessions (0.25 versus 0.95; P= 0.00094). The average volume of retropectoral AFT was 116.25 mL (SD 31.36). Six months after the procedure, the mean retropectoral fat volume calculated through magnetic resonance imaging was 48.64 mL (SD 14.15), whereas the mean graft integration rate was 45.98% (range, 30.7%–64.2%).
Conclusions:. The lipo-DIEP flap is a valuable technique for patients with insufficient donor-site volume. Immediate retropectoral fat grafting from the Holm zone IV has proven to be safe in terms of complications, reducing the need for further AFT sessions. |
| format | Article |
| id | doaj-art-fb357fd0b3c742fdbd41adb358718355 |
| institution | Kabale University |
| issn | 2169-7574 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj-art-fb357fd0b3c742fdbd41adb3587183552025-01-24T09:19:58ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742025-01-01131e644510.1097/GOX.0000000000006445202501000-00037The Lipo-DIEP Flap Breast Reconstruction: A Valuable Innovation for Maximizing Abdominal Tissue VolumeBenedetto Longo, MD, PhD0Gennaro D’Orsi, MD1Alessio Farcomeni, PhD2Martina Giacalone, MD3Elettra Gagliano4Lisa Vannucchi, MD5Maximilian Catenacci, MD6Gianluca Vanni, MD7Claudio Oreste Buonomo, MD8Valerio Cervelli, MD9From the * Department of Surgical Sciences, School of Medicine and Surgery, Tor Vergata University of Rome, Rome, ItalyFrom the * Department of Surgical Sciences, School of Medicine and Surgery, Tor Vergata University of Rome, Rome, Italy† Department of Economics and Finance, Tor Vergata University of Rome, Rome, ItalyFrom the * Department of Surgical Sciences, School of Medicine and Surgery, Tor Vergata University of Rome, Rome, ItalyFrom the * Department of Surgical Sciences, School of Medicine and Surgery, Tor Vergata University of Rome, Rome, ItalyFrom the * Department of Surgical Sciences, School of Medicine and Surgery, Tor Vergata University of Rome, Rome, ItalyFrom the * Department of Surgical Sciences, School of Medicine and Surgery, Tor Vergata University of Rome, Rome, Italy‡ Division of Breast Unit, Department of Surgical Sciences, School of Medicine and Surgery, Tor Vergata University of Rome, Rome, Italy.‡ Division of Breast Unit, Department of Surgical Sciences, School of Medicine and Surgery, Tor Vergata University of Rome, Rome, Italy.From the * Department of Surgical Sciences, School of Medicine and Surgery, Tor Vergata University of Rome, Rome, ItalyBackground:. The deep inferior epigastric perforator (DIEP) flap is universally considered the gold standard technique for breast reconstruction (BR), though it cannot always be proposed to patients with insufficient donor-site volume. We explore the efficacy of autologous fat transfer (AFT) of the Holm abdomen zone IV in the retropectoral plane during DIEP flap reconstruction (lipo-DIEP flap), to enhance the volume provided by the abdominal donor site in patients with low body mass index (BMI). Methods:. We prospectively enrolled patients with BMI less than 25 kg/m2 and candidates for lipo-DIEP flap BR (group A) comparing them with a control group (group B) undergoing traditional DIEP flap BR with the same characteristics of the first group (BMI < 25 kg/m2). Patients belonging to group A underwent magnetic resonance imaging preoperatively and 6 months after the BR, evaluating the adipose tissue volume retained in the retropectoral space. Results:. A total of 40 breasts were included in the study. The 2 groups were homogeneous regarding the collected variables, except for mean delayed AFT sessions (0.25 versus 0.95; P= 0.00094). The average volume of retropectoral AFT was 116.25 mL (SD 31.36). Six months after the procedure, the mean retropectoral fat volume calculated through magnetic resonance imaging was 48.64 mL (SD 14.15), whereas the mean graft integration rate was 45.98% (range, 30.7%–64.2%). Conclusions:. The lipo-DIEP flap is a valuable technique for patients with insufficient donor-site volume. Immediate retropectoral fat grafting from the Holm zone IV has proven to be safe in terms of complications, reducing the need for further AFT sessions.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006445 |
| spellingShingle | Benedetto Longo, MD, PhD Gennaro D’Orsi, MD Alessio Farcomeni, PhD Martina Giacalone, MD Elettra Gagliano Lisa Vannucchi, MD Maximilian Catenacci, MD Gianluca Vanni, MD Claudio Oreste Buonomo, MD Valerio Cervelli, MD The Lipo-DIEP Flap Breast Reconstruction: A Valuable Innovation for Maximizing Abdominal Tissue Volume Plastic and Reconstructive Surgery, Global Open |
| title | The Lipo-DIEP Flap Breast Reconstruction: A Valuable Innovation for Maximizing Abdominal Tissue Volume |
| title_full | The Lipo-DIEP Flap Breast Reconstruction: A Valuable Innovation for Maximizing Abdominal Tissue Volume |
| title_fullStr | The Lipo-DIEP Flap Breast Reconstruction: A Valuable Innovation for Maximizing Abdominal Tissue Volume |
| title_full_unstemmed | The Lipo-DIEP Flap Breast Reconstruction: A Valuable Innovation for Maximizing Abdominal Tissue Volume |
| title_short | The Lipo-DIEP Flap Breast Reconstruction: A Valuable Innovation for Maximizing Abdominal Tissue Volume |
| title_sort | lipo diep flap breast reconstruction a valuable innovation for maximizing abdominal tissue volume |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006445 |
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