A multicentre study of the relationship between abdominal flap and mastectomy weights in immediate unilateral free flap breast reconstruction and the effect of adjuvant radiotherapy

Abdominal free flaps are considered the gold standard for post-mastectomy autologous breast reconstruction. A key element of outcome assessment is breast symmetry often achieved by approximating the reconstructed breast dimensions such as weight (wt) to those of the mastectomy. However, the ideal re...

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Bibliographic Details
Published in:Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2022-01, Vol.75 (1), p.61-68
Main Authors: Di Pace, Bruno, Khan, Farhaan, Patel, Manal, Serlenga, Gabriella, Sorotos, Michail, Alfano, Carmine, Santanelli di Pompeo, Fabio, Rubino, Corrado, Malata, Charles M.
Format: Article
Language:English
Subjects:
Breast Neoplasms - radiotherapy
Breast Neoplasms - surgery
Breast radiotherapy
Breast symmetry
Contralateral balancing surgery
Female
Flap weights
Follow-Up Studies
Free Tissue Flaps
Humans
Immediate breast reconstruction
Ipsilateral revision surgery
Mammaplasty - methods
Mastectomy - methods
Postoperative Complications
Radiotherapy, Adjuvant
Retrospective Studies
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Summary:Abdominal free flaps are considered the gold standard for post-mastectomy autologous breast reconstruction. A key element of outcome assessment is breast symmetry often achieved by approximating the reconstructed breast dimensions such as weight (wt) to those of the mastectomy. However, the ideal relationship between these two entities remains unclear. 525 immediate unilateral abdominal free flap breast reconstruction (FFBR) patients were enrolled in a multicentre study (UK 141; Italy 384) and subdivided into Group A (flap wt < mastectomy wt, n = 163), Group B (flap wt > mastectomy wt, n = 260) and Group C (flap wt = mastectomy wt, n = 102). Their rates of contralateral balancing and ipsilateral revision surgeries were compared using Chi-Square tests. Radiotherapy influence on these adjustment procedures was also assessed. More contralateral balancing procedures (17%) were performed than ipsilateral revisions (10%). Group A rates of contralateral balancing procedures were three times higher than Group B's with a ratio of 37 to 1 versus Group C (37% vs 11% vs 1% respectively, p 
ISSN:1748-6815
1878-0539
DOI:10.1016/j.bjps.2021.06.010