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CC BY-NC-ND 4.0 · Indian J Plast Surg 2024; 57(02): 099-105
DOI: 10.1055/s-0044-1781447
Original Article

Longitudinal Volume Assessment of Reconstructed Breast Using Three-Dimensional Measurement: How Do DIEP and LD Flap Change Immediately after Surgery?

Authors

  • Hiroki Utsunomiya 

    1   Department of Surgery–Plastic Surgery, Showa University Koto Toyosu Hospital, Tokyo, Japan

  • Ryutaro Tanaka

    1   Department of Surgery–Plastic Surgery, Showa University Koto Toyosu Hospital, Tokyo, Japan

  • Shuryo Akamine

    1   Department of Surgery–Plastic Surgery, Showa University Koto Toyosu Hospital, Tokyo, Japan

  • Taro Kusano

    2   Kusano Taro Clinic, Tokyo, Japan

  • Tomoaki Kuroki

    3   Department of Plastic and Reconstructive Surgery, Showa University Hospital, Tokyo, Japan

  • Koichi Kadomatsu

    4   Department of Plastic and Reconstructive Surgery, Showa University Fujigaoka Hospital, Tokyo, Japan
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Abstract

Background The deep inferior epigastric perforator (DIEP) and latissimus dorsi (LD) flaps are two widely used autologous breast reconstructions. Despite studies on flap-volume changes, the time of the first measurement is not immediately after surgery. Therefore, this study aimed to investigate the change in volume over time from the immediate postoperative period using a three-dimensional (3D) scanner.

Methods Patients who underwent breast reconstruction with a DIEP or LD flap between October 2019 and December 2020 at Showa University Koto Toyosu Hospital were included. The Kinect 3D scanner was used to measure the reconstructed and healthy breast volumes immediately after surgery and at 1, 3, 6, and 12 months. The control group was the healthy side, and the volumes obtained at each time point and ratios (to the immediate postoperative period) were calculated and analyzed using a linear mixed model.

Results Of the 25 patients and 26 breasts examined, the postoperative increase in volume ratios was statistically significant in the DIEP flap group, except for the sixth month, but decreased significantly in the LD group. Compared with the control group, the volume ratio was significantly higher up to 3 months in the DIEP flap group and decreased significantly after 3 months in the LD flap group.

Conclusions The volume of the LD flap continued to decrease immediately after surgery, whereas the volume of the DIEP flap increased by 10% up to 1M. Therefore, this increase in volume should be taken into consideration in studies where the initial measurements were not taken immediately after surgery.

Keywords

breast reconstruction - latissimus dorsi - perforator flap - magnetic resonance imaging - supine position

Authors' Contributions

U.H. and K.K. conceived and designed the analysis. U.H., T.R., A.S., and K.T. helped in data collection.


U.H. and K.T. contributed to data/analysis tools.


U.H. performed the analysis and wrote the article.


Ethical Approval

Institutional Review Board approval was not obtained for this noninvasive, retrospective study based on patients conducted using their medical records. The study followed the principles of the Declaration of Helsinki, and written informed consent was obtained from all patients.




Publication History

Article published online:
18 March 2024

© 2024. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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