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Bilateral IGAP flaps suitable for breast reconstruction in patients with slim hips

In patients whose breast size is larger than a C cup with moderate projection and mastectomy weight greater than 350 g - specifically among those with slim hips and insufficient abdominal tissue - bilateral inferior gluteal artery perforator flaps can be utilized as a breast reconstruction alternative, according to researchers.

Among patients with slim hips, the use of a unilateral inferior gluteal artery perforator (IGAP) flap can result in the postoperative development of inferior gluteal crease displacement, and sufficient unilateral gluteal tissue may be lacking, according to the researchers. In addition, donor-site asymmetry is also a potential risk.

In a retrospective study, the researchers reviewed 20 unilateral breast reconstruction patients who underwent bilateral IGAP flap procedures and compared the results with those of 22 patients who underwent unilateral IGAP flap procedures.

Among the patients in the bilateral flap group, 39 of the 40 flaps survived, and one developed total necrosis from repeated venous thrombosis. The size of reconstructed breast was comparable to that of the contralateral breast in 15 of 20 patients, according to the researchers.

In bilateral flaps, the final inset flap weight was 462.3 g, and for unilateral flaps, final inset flap weight was 244.3 g.

Bilateral flap procedures were longer at a mean of 671.1 minutes, compared with 486.8 minutes for unilateral procedures.

Bilateral IGAP flap procedures were observed to provide abundant gluteal fat without causing significant gluteal deformity, according to the researchers. Bilateral flaps also allowed for more sufficient volume available for reconstruction and provided a good option for patients lacking abdominal tissue with moderate-to-high projection breasts. - by Abigail Sutton

Disclosure: The researchers reported no relevant financial disclosures.