Enhancing Breast Reshaping in Massive Weight Loss Patients: The Post-Bariatric DIEP Approach

IF 1.5 3区医学 Q3 SURGERY

Microsurgery Pub Date : 2025-03-03 DOI:10.1002/micr.70042

Isidoro Musmarra, Giuseppe A. G. Lombardo, Federico Barbera, Monica Vappiani, David Ragonez, Paola Aguilar, Corentin Taveau, Julien Quilichini

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引用次数: 0

Abstract

Background

Massive weight loss (MWL) patients often experience breast sequelae characterized by difficult-to-treat emptying and ptosis due to altered skin quality. Silicone prosthesis use is associated with a high rate of ptosis recurrence. The use of DIEP flap allows simultaneous treatment of breast and abdominal deformities. This study aims to present our experience using the DIEP-free flap as an autologous breast prosthesis for volumetric breast augmentation in the postbariatric population.

Methods

This study involved all postbariatric patients who underwent breast reshaping using a double DIEP-free flap. Patient demographics, operative details, and postoperative outcomes were evaluated. Patients filled out BREAST-Q and BODY-Q surveys both preoperatively and after 6 months to study the rate of satisfaction.

Results

Twenty patients underwent breast reshaping with double DIEP-free flap between September 2020 and October 2023. The average age was 30 years, with an average weight loss of 52.2 kg. Sleeve gastrectomy was the most common bariatric surgery procedure (75%). The average duration of surgeries was 461.38 min. The average length of stay was 6.5 days.

Two flaps required surgical revision, with one flap loss. Two complications have been registered for the donor site, one liponecrosis with wound dehiscence and one abdominal bulging. Statistically significant improvements were observed in satisfaction with breast appearance and psychological, physical, and sexual well-being.

Conclusions

In the postbariatric population, the DIEP flap represents a safe and reproducible surgical technique for addressing breast deformities. Autologous volumetric augmentation offers harmonious and stable long-term outcomes without secondary sequelae at the donor site.

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在大量减肥患者中加强乳房重塑：减重后的DIEP方法

背景：大量体重减轻（MWL）患者经常经历乳房后遗症，其特征是由于皮肤质量的改变而难以治疗的排空和上睑下垂。硅胶假体的使用与上睑下垂复发率高有关。使用DIEP皮瓣可以同时治疗乳房和腹部畸形。本研究旨在介绍我们在肥胖后人群中使用无diep皮瓣作为自体乳房假体进行体积性隆胸的经验。方法本研究纳入所有采用双DIEP-free皮瓣进行乳房重塑的减肥后患者。评估患者人口统计、手术细节和术后结果。患者术前和术后6个月分别填写BREAST-Q和BODY-Q问卷，以研究满意度。结果20例患者于2020年9月至2023年10月行双双无diep皮瓣乳房重塑术。平均年龄为30岁，平均体重减轻52.2公斤。袖式胃切除术是最常见的减肥手术（75%）。平均手术时间461.38 min。平均住院时间为6.5天。两个皮瓣需要手术修复，一个皮瓣丢失。供体部位有两例并发症，一例脂肪坏死伴伤口裂开，一例腹部隆起。从统计上看，乳房外观、心理、生理和性方面的满意度都有显著改善。结论在肥胖后人群中，DIEP皮瓣是一种安全、可重复的治疗乳房畸形的手术技术。自体体积增强术提供和谐和稳定的长期结果，没有供体部位的继发性后遗症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Microsurgery 医学-外科

CiteScore

3.80

自引率

19.00%

发文量

128

审稿时长

4-8 weeks

期刊介绍： Microsurgery is an international and interdisciplinary publication of original contributions concerning surgery under microscopic magnification. Microsurgery publishes clinical studies, research papers, invited articles, relevant reviews, and other scholarly works from all related fields including orthopaedic surgery, otolaryngology, pediatric surgery, plastic surgery, urology, and vascular surgery.