Limits...
Bilateral Breast Reconstruction with Extended Thoracodorsal Artery Perforator Propeller Flaps and Implants.

Gunnarsson GL, Børsen-Koch M, Nielsen HT, Salzberg A, Thomsen JB - Plast Reconstr Surg Glob Open (2015)

Bottom Line: Reconstruction was successfully achieved in all cases with few complications.The median time for surgery was 275 minutes (200-330), and the average implant size used was 350 cm(3) (195-650).We demonstrate how the extended thoracodorsal artery perforator propeller flap allows for a swift and reliable direct to implant bilateral total breast reconstruction in a simple setting and is a valuable adjunct to our armamentarium of techniques for single-stage bilateral breast reconstruction.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic Surgery, Telemark Hospital, Skien, Norway; Department of Plastic Surgery, Lillebaelt Hospital/Odense University Hospital, Vejle, Denmark; Department of Plastic Surgery, Odense University Hospital, Odense, Denmark; and Division of Plastic Surgery, Mount Sinai Medical System, N.Y.

ABSTRACT
We present our experience of bilateral total breast reconstruction using a double-sided extended thoracodorsal artery perforator propeller flap in a case series of 10 patients. Reconstruction was successfully achieved in all cases with few complications. The median time for surgery was 275 minutes (200-330), and the average implant size used was 350 cm(3) (195-650). We demonstrate how the extended thoracodorsal artery perforator propeller flap allows for a swift and reliable direct to implant bilateral total breast reconstruction in a simple setting and is a valuable adjunct to our armamentarium of techniques for single-stage bilateral breast reconstruction.

No MeSH data available.


Patient with an unsatisfactory result following immediate breast reconstruction shown before and after bilateral propeller eTAP flap breast reconstruction.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4494505&req=5

Figure 3: Patient with an unsatisfactory result following immediate breast reconstruction shown before and after bilateral propeller eTAP flap breast reconstruction.

Mentions: One-stage bilateral breast reconstruction using the eTAP flap was achieved in all cases (Fig. 3). We believe that the placement of implants in a subpectoral/hammock pocket at the breast footprint site is imperative to keep the implant from sliding laterally, causing compression on the vascular pedicle. The breast size and implants used were large and selected by measuring the width and height of the breast base dimensions. The projection was decided based upon patient wishes and intraoperative assessment of the vascular status of the flaps. Only 1 patient had an expander implant because of a nonpliable tissue envelope adjacent to the flap. Two patients experienced a unilateral complication. A hypertensive smoker had a partial necrosis of the flap needing revision, and another patient suffered a venous congestion because of a kinking of the pedicle. Both patients were reoperated on, and the reconstructive goals were achieved. The operative time was relatively fast compared with other single-stage techniques having a median duration of 4½ hours.


Bilateral Breast Reconstruction with Extended Thoracodorsal Artery Perforator Propeller Flaps and Implants.

Gunnarsson GL, Børsen-Koch M, Nielsen HT, Salzberg A, Thomsen JB - Plast Reconstr Surg Glob Open (2015)

Patient with an unsatisfactory result following immediate breast reconstruction shown before and after bilateral propeller eTAP flap breast reconstruction.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4494505&req=5

Figure 3: Patient with an unsatisfactory result following immediate breast reconstruction shown before and after bilateral propeller eTAP flap breast reconstruction.
Mentions: One-stage bilateral breast reconstruction using the eTAP flap was achieved in all cases (Fig. 3). We believe that the placement of implants in a subpectoral/hammock pocket at the breast footprint site is imperative to keep the implant from sliding laterally, causing compression on the vascular pedicle. The breast size and implants used were large and selected by measuring the width and height of the breast base dimensions. The projection was decided based upon patient wishes and intraoperative assessment of the vascular status of the flaps. Only 1 patient had an expander implant because of a nonpliable tissue envelope adjacent to the flap. Two patients experienced a unilateral complication. A hypertensive smoker had a partial necrosis of the flap needing revision, and another patient suffered a venous congestion because of a kinking of the pedicle. Both patients were reoperated on, and the reconstructive goals were achieved. The operative time was relatively fast compared with other single-stage techniques having a median duration of 4½ hours.

Bottom Line: Reconstruction was successfully achieved in all cases with few complications.The median time for surgery was 275 minutes (200-330), and the average implant size used was 350 cm(3) (195-650).We demonstrate how the extended thoracodorsal artery perforator propeller flap allows for a swift and reliable direct to implant bilateral total breast reconstruction in a simple setting and is a valuable adjunct to our armamentarium of techniques for single-stage bilateral breast reconstruction.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic Surgery, Telemark Hospital, Skien, Norway; Department of Plastic Surgery, Lillebaelt Hospital/Odense University Hospital, Vejle, Denmark; Department of Plastic Surgery, Odense University Hospital, Odense, Denmark; and Division of Plastic Surgery, Mount Sinai Medical System, N.Y.

ABSTRACT
We present our experience of bilateral total breast reconstruction using a double-sided extended thoracodorsal artery perforator propeller flap in a case series of 10 patients. Reconstruction was successfully achieved in all cases with few complications. The median time for surgery was 275 minutes (200-330), and the average implant size used was 350 cm(3) (195-650). We demonstrate how the extended thoracodorsal artery perforator propeller flap allows for a swift and reliable direct to implant bilateral total breast reconstruction in a simple setting and is a valuable adjunct to our armamentarium of techniques for single-stage bilateral breast reconstruction.

No MeSH data available.