Our Summary

This study discusses the use of a particular surgical technique known as the deep inferior epigastric perforator (DIEP) flap in outpatient breast enhancement surgery. The research involved patients who had undergone breast enhancement using DIEP flaps over a 12-month period. The procedure was considered for those who wanted breast augmentation, a change of implants, or a combination of breast lift and augmentation, along with tummy tucks.

The surgical method used included making very small cuts to remove the DIEP flaps and preserving the rib as well as protocols for quick recovery after surgery, including using anesthetic blocks during the operation.

The study involved 11 patients who had both breasts augmented using DIEP flaps and a breast lift. All of these patients reported being unhappy with their abdomen and breasts before the surgery. The small cuts made for removing the abdominal flaps averaged 1.7 cm for single perforator flaps and 2.4 cm for flaps with multiple perforators. The internal mammary artery vessels were dissected without disturbing the rib and no muscle or connective tissue was taken during flap dissection. All patients showed strong blood flow signals before being discharged within 23 hours. No partial or total flap losses, major complications, or returns for additional surgery were reported.

The study concludes that patients who want a tummy tuck and breast augmentation are ideal candidates for this procedure. Breast augmentation with the patient’s own tissue, particularly the DIEP flap, is a good option considering the additional abdominal tissue available for harvesting. The quick recovery protocol allows surgeons to perform microsurgical breast reconstructions and augmentations in an outpatient setting, with excellent results and no total or partial flap losses. This offsets the high costs associated with the DIEP flap.

FAQs

  1. What is a deep inferior epigastric perforator (DIEP) flap and how is it used in breast augmentation?
  2. Are there any risks or complications associated with breast augmentation using DIEP flaps?
  3. Who are considered ideal candidates for this procedure?

Doctor’s Tip

A helpful tip a doctor might tell a patient about breast augmentation with DIEP flaps is to follow the early recovery protocol provided, including taking care of the incisions and following post-operative instructions closely. This can help ensure a successful outcome and minimize the risk of complications. Additionally, maintaining a healthy lifestyle and following a proper post-operative care routine can also contribute to the overall success of the procedure.

Suitable For

Patients who desire breast augmentation, implant exchange, or augmentation mastopexy with concomitant abdominoplasty are typically recommended for breast augmentation with deep inferior epigastric perforator (DIEP) flaps. These patients are often dissatisfied with both their abdomen and breasts and are looking for a natural, autologous tissue-based augmentation option. The use of DIEP flaps allows for the harvesting of additional abdominal tissue, making it an attractive option for patients seeking both breast and abdominal cosmetic procedures. The early recovery protocol associated with DIEP flap procedures allows for outpatient surgery with excellent results and minimal complications, making it a viable option for eligible patients.

Timeline

Before breast augmentation with DIEP flaps:

  • Patients express dissatisfaction with their abdomen and breasts.
  • Patients undergo a consultation with a plastic surgeon to discuss the procedure.
  • Preoperative testing and preparation is done to ensure the patient is a suitable candidate for the procedure.

After breast augmentation with DIEP flaps:

  • Patients undergo the procedure, which involves harvesting tissue from the abdomen to create natural-looking breast augmentation.
  • Patients are monitored closely postoperatively for any complications.
  • Patients follow a strict recovery protocol, including early mobilization and avoiding strenuous activities.
  • Patients have regular follow-up appointments with their surgeon to monitor healing and address any concerns.

What to Ask Your Doctor

  1. Am I a good candidate for breast augmentation with DIEP flaps?
  2. What are the potential risks and complications associated with this procedure?
  3. How long is the recovery period and what can I expect during the recovery process?
  4. Will I need to have any additional procedures done in conjunction with the breast augmentation?
  5. How long do the results of the breast augmentation typically last?
  6. What type of scarring can I expect from the procedure?
  7. How many surgeries have you performed using DIEP flaps for breast augmentation?
  8. Can I see before and after photos of patients who have undergone breast augmentation with DIEP flaps?
  9. What is the cost associated with this procedure and does insurance cover any part of it?
  10. Are there any long-term effects or considerations I should be aware of before undergoing breast augmentation with DIEP flaps?

Reference

Authors: Martinez CA, Boutros SG. Journal: Plast Reconstr Surg. 2023 Feb 1;151(2):234e-240e. doi: 10.1097/PRS.0000000000009836. Epub 2022 Nov 11. PMID: 36354968