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Bilateral four-flap breast reconstruction with stacked DIEP, PAP flaps safe, effective

Stacking deep inferior epigastric perforator and profunda artery perforator flaps in four-flap breast reconstruction offers favorable aesthetic results in bilateral breast reconstruction patients who lack sufficient abdominal tissue, according to researchers.

Twenty patients underwent four-flap DIEP/PAP breast reconstruction.

The primary recipient vessels were the antegrade and retrograde internal mammary vessels.

The researchers reported no flap losses. Patient complications included one hematoma, one incident of arterial and venous thrombosis treated successfully with anastomotic revision, one incident of thigh donor site dehiscence, and three incidents of minor mastectomy skin flap necrosis.

The complications rates were similar to or lower than previously reported rates for one- and two-flap reconstructions.

The combination of stacked flaps is safe and efficient, according to researchers, and leads to superior aesthetic results. – by Abigail Sutton

Disclosure: The researchers reported no relevant financial disclosures.