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J Reconstr Microsurg
DOI: 10.1055/a-2483-5472
Original Article

Deep Inferior Epigastric Perforator Flap with Implant Placement has a Favorable Complication Profile Compared with Implant-Only or Flap-Only Reconstruction

Carol Wang 
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
,
Nikita Roy
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
,
Keisha E. Montalmant
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
,
Peter Shamamian
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
,
Nargiz Seyidova
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
,
Olachi Oleru 
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
,
Francis Graziano
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
,
Jordan M.S. Jacobs
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
,
Hani Sbitany
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
,
Peter W. Henderson
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
› Author Affiliations Funding O.O. was supported by the National Center for Advancing Translational Sciences (NCATS) TL1TR004420 NRSA TL1 Training Core in Transdisciplinary Clinical and Translational Science (CTSA).
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Abstract

Background Hybrid deep inferior epigastric perforator (DIEP) flap and simultaneous silicone implant breast reconstruction procedures (“DIEP + I”) have many conceptual advantages compared with either reconstruction method alone, but the outcomes of DIEP + I reconstruction have not yet been well studied. Therefore, the purpose of this study was to compare the outcomes of DIEP + I with implant-only and DIEP-only reconstruction.

Methods A retrospective review was conducted of patients undergoing DIEP + I, implant-only, and DIEP-only breast reconstruction from 2019 to 2023 at a single institution. Demographics and complication rates were compared between groups.

Results A total of 145 patients were included in the DIEP + I (N = 26), implant-only (N = 59), and DIEP-only (N = 60) groups. The DIEP + I group had a lower overall complication rate than implant-only reconstruction (18.4 vs. 41.1%, p = 0.014), which was primarily due to the lower incidence of infections in the DIEP + I group (2.6 vs. 22.2%, p = 0.006). Accordingly, DIEP + I reconstruction decreased the odds of infection by 90% (OR = 0.095, p = 0.024) compared with implant-only reconstruction. The DIEP + I group had similar rates of wound healing and implant-related complications compared with the implant-only and DIEP-only groups, and no patients in the DIEP + I group experienced flap loss.

Conclusion DIEP + I breast reconstruction had a lower rate of infectious complications than implant-only reconstruction, and no higher rate of flap compromise or wound healing complications. This technique could be considered as a means of minimizing infection risk in patients with other risk factors who are seeking implant-based reconstruction, and of enhancing breast projection in patients who are seeking DIEP flap reconstruction.

Keywords

hybrid breast reconstruction - breast implants - DIEP flap - postoperative complications - comparative study - autologous reconstruction

Notes

This study was IRB-approved (STUDY-20–01356). All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). We obtained a waiver of informed consent due to the nature of the data.




Publication History

Received: 26 June 2024

Accepted: 10 November 2024

Accepted Manuscript online:
25 November 2024

Article published online:
23 December 2024

© 2024. Thieme. All rights reserved.

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