Contralateral breast symmetrisation in unilateral DIEP flap breast reconstruction

This paper is focused on whether an immediate breast symmetrisation procedure is beneficial when a patient undergoes contralateral breast resection plus an immediate free flap reconstruction for breast cancer. Free abdominal perforator flaps (DIEP) generally offer the highest postoperative satisfaction...

ERAS in microvascular breast reconstruction

Enhanced recovery after surgery (ERAS) is an important concept in today’s accountancy dominated hospitals, effectively decreasing the length of stay (LOS) of postoperative patients. This is something that surgeons will have to consider – or have protocols foisted upon them...

Abdominal problems following breast reconstruction using lower abdominal flaps

Abdominal problems following transverse rectus abdominis myocutaneous (TRAM) and deep inferior epigastric perforators (DIEP) flaps are well recognised in these otherwise excellent methods of breast reconstruction. The authors reviewed 399 patients, of whom 57.7% had surgical complications although most of...

Additional venous anastomoses to safeguard DIEP flaps

That DIEP flaps can be troublesome is not news and many descriptions exist trying to circumvent these problems. The most common problem is venous congestion in the flap and this paper presents an ingenious method of anticipating and forestalling such...

Modifying the DIEP flap in autologous breast reconstruction, introducing a fifth ‘Fleur-de-lis’ zone

With current consumer disquiet about silicone implants, more patients may request autologous reconstruction. This can cause difficulties in patients who have undergone massive weight loss. The authors describe an ingenious solution, modifying the deep inferior epigastric perforators (DIEP) flap to...