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Pre-operative predictive estimation of abdominal flap volume for breast reconstruction using ultrasound and an anthropometric method

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Abstract

Background

The abdominal flap has proven to be an optimal autologous option for breast reconstruction. However, the feasibility of breast reconstruction using an abdominal flap should be determined pre-operatively, especially in lean patients. In order to achieve optimal symmetry when using an abdominal flap for breast reconstruction, a specific amount of abdominal tissue is required and this should be estimated prior to surgery.

Methods

Patients with unilateral modified radical mastectomies requesting delayed breast reconstruction had their abdominal flap volume measured pre-operatively using a measuring tape and ultrasound. Contralateral breast volume was also measured using magnetic resonance imaging and was compared to the abdominal flap volume. Additionally, body mass index was measured for every patient. A correlation between each patient’s body mass index, contralateral breast volume, and abdominal flap volume was calculated.

Results

Twenty patients with a mean age of 39 years (range 26–49 years, SD 6) and a mean body mass index of 29 (range 23–35, SD 4) were included in this study. The mean breast volume was 620 cm3, and the mean abdominal flap volume was 770 cm3 (excluding zone IV). The mean breast volume to abdominal flap volume ratio (without zone IV) was 0.8.

Conclusions

Our pre-operative measurements of breast volume, abdominal flap volume, and body mass index enabled us to establish a relationship between these variables and to determine the feasibility of surgery and the need for additional volume enhancement and breast symmetrization procedures in patients seeking breast reconstruction.

Level of Evidence: Level IV, risk/prognostic study.

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Authors and Affiliations

  1. Division of Plastic Surgery, Cairo University, Cairo, Egypt

    Ahmed A. Taha, Ayman El Noman, Tarek A. Mahboub, Amr A. Zaki, Rasha W. Abd El-Rahman, M. El Essawy & Ahmed T. Ismail

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  1. Ahmed A. Taha
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  2. Ayman El Noman
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  3. Tarek A. Mahboub
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  4. Amr A. Zaki
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  5. Rasha W. Abd El-Rahman
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  6. M. El Essawy
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  7. Ahmed T. Ismail
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Correspondence to Ahmed A. Taha.

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Funding

This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.

Conflict of interest

Ahmed A. Taha, Ayman El Noman, Tarek A. Mahboub, Amr A. Zaki, Rasha W. Abd El-Rahman, M. El Essawy, and Ahmed T. Ismail declare that they have no conflict of interest.

Ethical approval

All procedures in studies involving human participants were performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Patient consent

Patients provided written or verbal consent before their inclusion in this study.

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Taha, A.A., El Noman, A., Mahboub, T.A. et al. Pre-operative predictive estimation of abdominal flap volume for breast reconstruction using ultrasound and an anthropometric method. Eur J Plast Surg 41, 653–662 (2018). https://doi.org/10.1007/s00238-018-1412-5

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  • DOI: https://doi.org/10.1007/s00238-018-1412-5

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