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Identifying Preoperative Factors Associated with the Volume Discrepancy in Patients Undergoing Breast Reconstruction with the Extended Latissimus Dorsi Musculocutaneous Flap Coverage

  • Original Article
  • Breast Surgery
  • Published:
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Abstract

Background

The latissimus dorsi (LD) flap is a versatile option for breast reconstruction. However, the indications are limited because of volume discrepancy between the breast and the flap. We conducted this study to identify preoperative factors associated with the volume discrepancy in patients undergoing breast reconstruction with the extended LD flap.

Methods

A retrospective study was performed in 69 patients (69 breasts) who underwent breast reconstruction with the extended LD flap between March 2015 and March 2018. We evaluated age, body weight, height, preoperative body mass index (BMI), postoperative BMI, breast skin defect size, breast volume, flap volume, and volume discrepancy [breast volume − flap volume].

Results

Mean age, height, body weight, preoperative BMI, postoperative BMI, skin defect size, breast volume, flap volume, and volume discrepancy were 45.6 ± 7.1, 157.8 ± 0.1, 59 ± 8.1, 23.7 ± 3.2, 23.5 ± 3.3, 16.5 ± 9.3, 252.2 ± 107.1, 229.4 ± 95.6, and 32.6 ± 31.4, respectively. Spearman’s rank correlation coefficients indicated significant positive linear correlations between volume discrepancy and preoperative BMI (correlation coefficient = 0.267, P = 0.027), volume discrepancy and breast volume (correlation coefficient = 0.472, P < 0.001), and between volume discrepancy and skin defect size (correlation coefficient = 0.609, P < 0.001). Stepwise multiple regression analysis yielded the following formula: predicted log volume discrepancy (ml) = 1.2891 + 0.0639 × skin defect size + 0.0025 × breast volume (R2 = 0.421).

Conclusion

Skin defect size and breast volume were preoperative factors associated with volume discrepancy in patients who have undergone breast reconstruction with the extended LD flap. Considering these factors, we can predict the lack of volume and plan any necessary secondary procedures.

Level of Evidence IV

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea

    Jun Hyeok Kim, Jong Keun Song, Sang Oon Baek, Jun Yong Lee, Gyeol Yoo & Eun Young Rha

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  1. Jun Hyeok Kim
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  2. Jong Keun Song
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  3. Sang Oon Baek
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Correspondence to Eun Young Rha.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Supplementary Figure 1. Volumetric measurement of the breast by CT (TIFF 380 kb)

Supplementary Figure 2. Photograph of the skin defect of the breast after mastectomy (TIFF 6242 kb)

Supplementary Figure 3. Photograph of the harvested extended LD flap (TIFF 2338 kb)

266_2019_1417_MOESM4_ESM.tif

Supplementary Figure 4. Preoperative CT scan. The breast volume was measured in the axial section of right breast. (white arrow) (TIFF 461 kb)

266_2019_1417_MOESM5_ESM.tif

Supplementary Figure 5. Postoperative CT scan. The reconstructed right breast with extended LD flap is shown in the axial section. (yellow arrow) (TIFF 516 kb)

Supplementary Table 1. Baseline characteristics of patients (XLSX 17 kb)

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Kim, J.H., Song, J.K., Baek, S.O. et al. Identifying Preoperative Factors Associated with the Volume Discrepancy in Patients Undergoing Breast Reconstruction with the Extended Latissimus Dorsi Musculocutaneous Flap Coverage. Aesth Plast Surg 43, 1490–1496 (2019). https://doi.org/10.1007/s00266-019-01417-2

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  • DOI: https://doi.org/10.1007/s00266-019-01417-2

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