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Open AccessArticle

Bilateral Simultaneous Breast Reconstruction with DIEP- and TMG Flaps: Head to Head Comparison, Risk and Complication Analysis

1
Department of Plastic and Reconstructive Surgery, Marienhospital Stuttgart, Teaching Hospital of the Eberhard Karls University Tuebingen, Germany, Boeheimstr 37, 70199 Stuttgart, Germany
2
Department of Plastic and Reconstructive Surgery, Hospital of the Brothers of St. John of God (Barmherzige Brüder), Paracelsus Medical University Salzburg, Austria, Kajetanerpl 1, 5010 Salzburg, Austria
*
Authors to whom correspondence should be addressed.
Both authors have contributed equally to this work.
J. Clin. Med. 2020, 9(7), 2031; https://doi.org/10.3390/jcm9072031
Received: 3 May 2020 / Revised: 11 June 2020 / Accepted: 16 June 2020 / Published: 28 June 2020
(This article belongs to the Special Issue Clinical Guidance for Breast Reconstruction)
Background: A two center retrospective cohort study of simultaneous bilateral breast reconstructions using double deep inferior epigastric perforator (DIEP) flaps and double transverse myocutaneous/upper gracilis (TMG) flaps was conducted. The aim of this study was to compare surgical procedures, complications, and overall outcome. Patients and Methods: Two study groups, either receiving a simultaneous bilateral breast reconstruction, with double DIEP flaps (n = 152) in group 1, or double TMG flaps (n = 86) in group 2, were compared. A detailed risk and complication analysis was performed. Patient characteristics, operative time and the need for further operations were evaluated. Results: Double DIEP patients had donor site complications in 23.7% and double TMG patients in 16.3% (p = 0.9075, RR 1.45). Flap loss rates of 3.5% (double TMG) and 2.6% (double DIEP) were recorded (p = 0.7071, RR 1.33). The need for postoperative lipofilling was significantly higher in double TMG patients (65.1% vs. 38.2 %, p = 0.0047, RR 1.71). Conclusion: Complication analysis favors the double DIEP procedure. Donor site morbidity was lower and less severe in the double TMG group. Later fat grafting was more frequently needed after double TMG reconstructions. Further studies, preferably of prospective nature, are needed to evaluate the benefit of bilateral simultaneous breast reconstructions. View Full-Text
Keywords: free flaps; microsurgical; double free flap; breast reconstruction; microsurgery; DIEP; TMG; TUG; muscle, gracilis; mammary cancer; DCIS free flaps; microsurgical; double free flap; breast reconstruction; microsurgery; DIEP; TMG; TUG; muscle, gracilis; mammary cancer; DCIS
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MDPI and ACS Style

Weitgasser, L.; Schwaiger, K.; Medved, F.; Hamler, F.; Wechselberger, G.; Schoeller, T. Bilateral Simultaneous Breast Reconstruction with DIEP- and TMG Flaps: Head to Head Comparison, Risk and Complication Analysis. J. Clin. Med. 2020, 9, 2031.

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