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Patients’ Aesthetic Concerns After Horizontally Placed Abdominal Free Flap Breast Reconstruction

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Abstract

Purpose

The present study aimed to analyze patients’ aesthetic concerns after breast reconstruction with abdominal free flap by reporting secondary cosmetic procedures performed based on the patients’ request, and analyzed the effect of adjuvant therapies and other variables on such outcomes.

Methods

All patients who underwent unilateral immediate reconstruction were enrolled prospectively. Free abdominal flaps were placed horizontally with little manipulation. Secondary procedures were actively recommended during the follow-up period to meet the patients’ aesthetic concerns. The numbers and types of the secondary procedures and the effects of various factors were analyzed.

Results

150 patients met the eligibility criteria. The average number of overall secondary surgeries per patient was 1.25. Patients with skin-sparing mastectomy required significantly higher number of secondary surgeries compared with those who underwent nipple-areolar skin-sparing mastectomy. When confined to the cosmetic procedures, 58 (38.7 %) patients underwent 75 operations. The most common procedures were flank dog ear revision, fat injection of the reconstructed breast, and breast liposuction. None of the radiated patients underwent liposuction of the flap. Most commonly liposuctioned regions were the central-lateral and lower-lateral, while fat was most commonly injected to the upper-medial and upper-central part of the breast.

Conclusion

The present study delineated the numbers and types of the secondary operations after horizontally placed abdominal free flap transfer with analysis of the influence of various factors. Addressing such issues during the primary reconstruction would help to reduce the need and extent of the secondary operations and to maximize aesthetic outcome.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Acknowledgments

The authors would like to thank Hyomin Choi at the University of Chicago for her assistance with data analysis.

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Authors and Affiliations

  1. Department of Plastic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, 88 Olympic ro 43 Gil, Songpa gu, Seoul, 138-736, Korea

    Eun Key Kim, Young Chul Suh, Jiyoung Yun & Taik Jong Lee

  2. Section of Plastic and Reconstructive Surgery, Department of Surgery, The University of Chicago Medical Center, Chicago, IL, USA

    Andrés A. Maldonado

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  1. Eun Key Kim
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  2. Young Chul Suh
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  3. Andrés A. Maldonado
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  4. Jiyoung Yun
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Correspondence to Eun Key Kim.

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The authors declare that they have no conflict of interest.

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Kim, E.K., Suh, Y.C., Maldonado, A.A. et al. Patients’ Aesthetic Concerns After Horizontally Placed Abdominal Free Flap Breast Reconstruction. Aesth Plast Surg 39, 686–693 (2015). https://doi.org/10.1007/s00266-015-0532-6

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  • DOI: https://doi.org/10.1007/s00266-015-0532-6

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