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Keywords = conjoined flap

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16 pages, 3289 KB  
Review
Pushing the DIEP Envelope: Where Are We Now?
by Chase Clark, David A. Daar and Ara A. Salibian
J. Clin. Med. 2025, 14(17), 6248; https://doi.org/10.3390/jcm14176248 - 4 Sep 2025
Cited by 3 | Viewed by 1501
Abstract
The deep inferior epigastric perforator (DIEP) flap in breast reconstruction has been an evolution in providing an ideal autologous reconstruction while minimizing donor site morbidity. Innovations have continued to optimize the DIEP flap in multiple facets. Alternative flap designs, vasculature modifications, and conjoined [...] Read more.
The deep inferior epigastric perforator (DIEP) flap in breast reconstruction has been an evolution in providing an ideal autologous reconstruction while minimizing donor site morbidity. Innovations have continued to optimize the DIEP flap in multiple facets. Alternative flap designs, vasculature modifications, and conjoined and stacked flaps have improved the ability to increase flap volume and perfusion. Advancements in anatomic understanding of the abdomen have resulted in decreases in donor site morbidity and improved abdominal outcomes. Patient satisfaction regarding aesthetics has been enhanced through careful consideration of mastectomy techniques and recipient site modifications in addition to improved quality of life outcomes through sensory innervation. The study reviews the evolution and current state of abdominally-based breast reconstruction in its goal of optimizing aesthetic, patient-reported and quality-of-life outcomes while minimizing complications. Full article
(This article belongs to the Special Issue Current State of the Art in Breast Reconstruction)
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14 pages, 58424 KB  
Review
Multi-Flap Microsurgical Autologous Breast Reconstruction
by Thomas N. Steele, Sumeet S. Teotia and Nicholas T. Haddock
J. Clin. Med. 2024, 13(17), 5324; https://doi.org/10.3390/jcm13175324 - 9 Sep 2024
Cited by 5 | Viewed by 2453
Abstract
Microsurgical autologous breast reconstruction (MABR) remains the gold standard technique of breast reconstruction, providing a durable, natural, and aesthetically pleasing result. However, some patients may not be candidates for a traditional deep inferior epigastric perforator (DIEP) flap, either due to abdominal tissue paucity, [...] Read more.
Microsurgical autologous breast reconstruction (MABR) remains the gold standard technique of breast reconstruction, providing a durable, natural, and aesthetically pleasing result. However, some patients may not be candidates for a traditional deep inferior epigastric perforator (DIEP) flap, either due to abdominal tissue paucity, the need for higher-volume reconstruction, or prior surgical procedures. In these patients, alternative flaps must be considered to achieve the optimal result. Such configurations include the conjoined (or double pedicle) DIEP flap, and alternative flaps such as the lumbar artery perforator (LAP) and profunda artery perforator (PAP) flaps, which can be combined in a stacked fashion. By combining multiple flaps in a conjoined or stacked fashion, breast reconstruction can be optimized to fulfill the three critical components of breast reconstruction in restoring the skin envelope, breast footprint, and conus shape. When harvesting multiple flaps, the surgical sequence of events must be meticulously planned to ensure an efficient and successful operation. Preoperative imaging can aid the surgeon in identifying the ideal perforator, assess for side branches for possible intra-flap anastomoses, expedite the operative time, and decrease intraoperative complications. Reconstructive surgeons should be familiar with the variety of configurations with conjoined and/or stacked flaps to address patient-specific reconstructive needs. Full article
(This article belongs to the Special Issue Current Research Trends and Updates in Breast Reconstruction)
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