Analysis of flap thickness to breast projection ratio correlating to body mass index and age in east Asian women: Considerations in flap selection in breast reconstruction
Background Several alternative flaps have been introduced and used for autologous breast reconstruction. However, as body fat distribution is different among patients, the donor of choice for sufficient breast projection varies between patients. Methods Patients who underwent autologous breast recon...
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| Veröffentlicht in: | Microsurgery 2024-05, Vol.44 (4), p.e31177-n/a |
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| creator | Kim, Hyung Bae Kim, Young Song Eom, Jin Sup Han, Hyun Ho |
| description | Background
Several alternative flaps have been introduced and used for autologous breast reconstruction. However, as body fat distribution is different among patients, the donor of choice for sufficient breast projection varies between patients.
Methods
Patients who underwent autologous breast reconstruction from Jan 2018 to Sep 2022 were included. Age, body mass index (BMI), smoking history and hypertension, and diabetes occurrence were collected as baseline demographic data. Breast projection with five types of flap thickness was measured based on computed tomography angiography. Analysis was performed for five major autologous flaps for breast reconstruction.
Results
A total of 563 patients were included in the study. The mean age of the patients was 47.4 ± 7.9 (standard deviation; SD) years. The mean BMI of the patients was 24.0 ± 3.4 kg/m2. Only the correlation between flap thickness to breast projection ratio and age in the PAP flap illustrated statistical significance (p = .039), but the correlation coefficient was quite low (r = −0.087). Slim patients who had lower BMIs (under 25 kg/m2) had significantly higher sufficient flap thickness for breast reconstruction than patients with higher BMIs over 25 kg/m2 in the profunda artery perforator (PAP) flap (p |
| doi_str_mv | 10.1002/micr.31177 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_3055853075</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3055853075</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2837-1c730f9722eafb0771a23b643be1900395bff56833ca6209a1e420359307bae73</originalsourceid><addsrcrecordid>eNp9kc1O3DAUha0KVAbaTR-gssQOKXBt43HMbjSCgkSFhOg6cpwb6mliD3ZGMM_ES9aTTFl2df3znXNkH0K-MThnAPyidzaeC8aU-kRmDHRZcCX5AZmBEmXBoJRH5DilFQBorfRnciRKqYFLPSPvC2-6bXKJhpa2nVnT4bezfzymRIdA64gmDXQdwwrt4IKn0eRBbYgRu7z0zyMWmi3tTdY43-AbNb6h5hnzjo76RXLG09fQo7-iy-CTa3A08jvFlJuw20fkk31uRJuRIW7Giy_ksDVdwq_7eUJ-3Vw_LW-L-4cfd8vFfWF5KVTBrBLQasU5mrYGpZjhop5fihqZBhBa1m0r56UQ1sw5aMPwkoOQWoCqDSpxQk4n3_zslw2moVqFTcz_lCoBUpYygzJTZxNlY0gpYluto-tN3FYMql0v1a6Xauwlw9_3lpu6x-YD_VdEBtgEvLoOt_-xqn7eLR8n079SUJsA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3055853075</pqid></control><display><type>article</type><title>Analysis of flap thickness to breast projection ratio correlating to body mass index and age in east Asian women: Considerations in flap selection in breast reconstruction</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Kim, Hyung Bae ; Kim, Young Song ; Eom, Jin Sup ; Han, Hyun Ho</creator><creatorcontrib>Kim, Hyung Bae ; Kim, Young Song ; Eom, Jin Sup ; Han, Hyun Ho</creatorcontrib><description>Background
Several alternative flaps have been introduced and used for autologous breast reconstruction. However, as body fat distribution is different among patients, the donor of choice for sufficient breast projection varies between patients.
Methods
Patients who underwent autologous breast reconstruction from Jan 2018 to Sep 2022 were included. Age, body mass index (BMI), smoking history and hypertension, and diabetes occurrence were collected as baseline demographic data. Breast projection with five types of flap thickness was measured based on computed tomography angiography. Analysis was performed for five major autologous flaps for breast reconstruction.
Results
A total of 563 patients were included in the study. The mean age of the patients was 47.4 ± 7.9 (standard deviation; SD) years. The mean BMI of the patients was 24.0 ± 3.4 kg/m2. Only the correlation between flap thickness to breast projection ratio and age in the PAP flap illustrated statistical significance (p = .039), but the correlation coefficient was quite low (r = −0.087). Slim patients who had lower BMIs (under 25 kg/m2) had significantly higher sufficient flap thickness for breast reconstruction than patients with higher BMIs over 25 kg/m2 in the profunda artery perforator (PAP) flap (p < .001), the lumbar artery perforator (LAP) flap (p < .001), and the superior gluteal artery perforator (SGAP) flap (p < .001).
Conclusions
The deep inferior epigastric perforator flap provided sufficient thickness and was not usually affected by age and BMI. The PAP, LAP, and SGAP flaps tended to maintain the thickness of the flap even when BMI decreased, so they are advantageous for reconstruction in slim patients. This study contributes evidence in consideration of flap selection in autologous breast reconstruction.</description><identifier>ISSN: 0738-1085</identifier><identifier>EISSN: 1098-2752</identifier><identifier>DOI: 10.1002/micr.31177</identifier><identifier>PMID: 38590259</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Age ; Angiography ; Body fat ; Body mass index ; Body size ; Breast ; Computed tomography ; Correlation coefficient ; Correlation coefficients ; Diabetes mellitus ; Hypertension ; Mean ; Thickness measurement</subject><ispartof>Microsurgery, 2024-05, Vol.44 (4), p.e31177-n/a</ispartof><rights>2024 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2837-1c730f9722eafb0771a23b643be1900395bff56833ca6209a1e420359307bae73</cites><orcidid>0000-0001-7072-9882</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fmicr.31177$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fmicr.31177$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38590259$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Hyung Bae</creatorcontrib><creatorcontrib>Kim, Young Song</creatorcontrib><creatorcontrib>Eom, Jin Sup</creatorcontrib><creatorcontrib>Han, Hyun Ho</creatorcontrib><title>Analysis of flap thickness to breast projection ratio correlating to body mass index and age in east Asian women: Considerations in flap selection in breast reconstruction</title><title>Microsurgery</title><addtitle>Microsurgery</addtitle><description>Background
Several alternative flaps have been introduced and used for autologous breast reconstruction. However, as body fat distribution is different among patients, the donor of choice for sufficient breast projection varies between patients.
Methods
Patients who underwent autologous breast reconstruction from Jan 2018 to Sep 2022 were included. Age, body mass index (BMI), smoking history and hypertension, and diabetes occurrence were collected as baseline demographic data. Breast projection with five types of flap thickness was measured based on computed tomography angiography. Analysis was performed for five major autologous flaps for breast reconstruction.
Results
A total of 563 patients were included in the study. The mean age of the patients was 47.4 ± 7.9 (standard deviation; SD) years. The mean BMI of the patients was 24.0 ± 3.4 kg/m2. Only the correlation between flap thickness to breast projection ratio and age in the PAP flap illustrated statistical significance (p = .039), but the correlation coefficient was quite low (r = −0.087). Slim patients who had lower BMIs (under 25 kg/m2) had significantly higher sufficient flap thickness for breast reconstruction than patients with higher BMIs over 25 kg/m2 in the profunda artery perforator (PAP) flap (p < .001), the lumbar artery perforator (LAP) flap (p < .001), and the superior gluteal artery perforator (SGAP) flap (p < .001).
Conclusions
The deep inferior epigastric perforator flap provided sufficient thickness and was not usually affected by age and BMI. The PAP, LAP, and SGAP flaps tended to maintain the thickness of the flap even when BMI decreased, so they are advantageous for reconstruction in slim patients. This study contributes evidence in consideration of flap selection in autologous breast reconstruction.</description><subject>Age</subject><subject>Angiography</subject><subject>Body fat</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Breast</subject><subject>Computed tomography</subject><subject>Correlation coefficient</subject><subject>Correlation coefficients</subject><subject>Diabetes mellitus</subject><subject>Hypertension</subject><subject>Mean</subject><subject>Thickness measurement</subject><issn>0738-1085</issn><issn>1098-2752</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kc1O3DAUha0KVAbaTR-gssQOKXBt43HMbjSCgkSFhOg6cpwb6mliD3ZGMM_ES9aTTFl2df3znXNkH0K-MThnAPyidzaeC8aU-kRmDHRZcCX5AZmBEmXBoJRH5DilFQBorfRnciRKqYFLPSPvC2-6bXKJhpa2nVnT4bezfzymRIdA64gmDXQdwwrt4IKn0eRBbYgRu7z0zyMWmi3tTdY43-AbNb6h5hnzjo76RXLG09fQo7-iy-CTa3A08jvFlJuw20fkk31uRJuRIW7Giy_ksDVdwq_7eUJ-3Vw_LW-L-4cfd8vFfWF5KVTBrBLQasU5mrYGpZjhop5fihqZBhBa1m0r56UQ1sw5aMPwkoOQWoCqDSpxQk4n3_zslw2moVqFTcz_lCoBUpYygzJTZxNlY0gpYluto-tN3FYMql0v1a6Xauwlw9_3lpu6x-YD_VdEBtgEvLoOt_-xqn7eLR8n079SUJsA</recordid><startdate>202405</startdate><enddate>202405</enddate><creator>Kim, Hyung Bae</creator><creator>Kim, Young Song</creator><creator>Eom, Jin Sup</creator><creator>Han, Hyun Ho</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7T5</scope><scope>7T7</scope><scope>7TK</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><orcidid>https://orcid.org/0000-0001-7072-9882</orcidid></search><sort><creationdate>202405</creationdate><title>Analysis of flap thickness to breast projection ratio correlating to body mass index and age in east Asian women: Considerations in flap selection in breast reconstruction</title><author>Kim, Hyung Bae ; Kim, Young Song ; Eom, Jin Sup ; Han, Hyun Ho</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2837-1c730f9722eafb0771a23b643be1900395bff56833ca6209a1e420359307bae73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Age</topic><topic>Angiography</topic><topic>Body fat</topic><topic>Body mass index</topic><topic>Body size</topic><topic>Breast</topic><topic>Computed tomography</topic><topic>Correlation coefficient</topic><topic>Correlation coefficients</topic><topic>Diabetes mellitus</topic><topic>Hypertension</topic><topic>Mean</topic><topic>Thickness measurement</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Hyung Bae</creatorcontrib><creatorcontrib>Kim, Young Song</creatorcontrib><creatorcontrib>Eom, Jin Sup</creatorcontrib><creatorcontrib>Han, Hyun Ho</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>Microsurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Hyung Bae</au><au>Kim, Young Song</au><au>Eom, Jin Sup</au><au>Han, Hyun Ho</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Analysis of flap thickness to breast projection ratio correlating to body mass index and age in east Asian women: Considerations in flap selection in breast reconstruction</atitle><jtitle>Microsurgery</jtitle><addtitle>Microsurgery</addtitle><date>2024-05</date><risdate>2024</risdate><volume>44</volume><issue>4</issue><spage>e31177</spage><epage>n/a</epage><pages>e31177-n/a</pages><issn>0738-1085</issn><eissn>1098-2752</eissn><abstract>Background
Several alternative flaps have been introduced and used for autologous breast reconstruction. However, as body fat distribution is different among patients, the donor of choice for sufficient breast projection varies between patients.
Methods
Patients who underwent autologous breast reconstruction from Jan 2018 to Sep 2022 were included. Age, body mass index (BMI), smoking history and hypertension, and diabetes occurrence were collected as baseline demographic data. Breast projection with five types of flap thickness was measured based on computed tomography angiography. Analysis was performed for five major autologous flaps for breast reconstruction.
Results
A total of 563 patients were included in the study. The mean age of the patients was 47.4 ± 7.9 (standard deviation; SD) years. The mean BMI of the patients was 24.0 ± 3.4 kg/m2. Only the correlation between flap thickness to breast projection ratio and age in the PAP flap illustrated statistical significance (p = .039), but the correlation coefficient was quite low (r = −0.087). Slim patients who had lower BMIs (under 25 kg/m2) had significantly higher sufficient flap thickness for breast reconstruction than patients with higher BMIs over 25 kg/m2 in the profunda artery perforator (PAP) flap (p < .001), the lumbar artery perforator (LAP) flap (p < .001), and the superior gluteal artery perforator (SGAP) flap (p < .001).
Conclusions
The deep inferior epigastric perforator flap provided sufficient thickness and was not usually affected by age and BMI. The PAP, LAP, and SGAP flaps tended to maintain the thickness of the flap even when BMI decreased, so they are advantageous for reconstruction in slim patients. This study contributes evidence in consideration of flap selection in autologous breast reconstruction.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>38590259</pmid><doi>10.1002/micr.31177</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-7072-9882</orcidid></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Age Angiography Body fat Body mass index Body size Breast Computed tomography Correlation coefficient Correlation coefficients Diabetes mellitus Hypertension Mean Thickness measurement |
| title | Analysis of flap thickness to breast projection ratio correlating to body mass index and age in east Asian women: Considerations in flap selection in breast reconstruction |
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