Total breast reconstruction with a fat-augmented latissimus dorsi flap: A comparative study between muscle and myocutaneous flaps
The fat-augmented latissimus dorsi myocutaneous flap can overcome the volume insufficiency of latissimus dorsi flaps by immediate fat grafting into the flap. When breast skin supplementation is unnecessary, latissimus dorsi flaps can be harvested as a muscle flap to avoid an additional back incision...
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| Veröffentlicht in: | Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2023-08, Vol.83, p.250-257 |
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| creator | Tomita, Koichi Taminato, Mifue Kubo, Tateki |
| description | The fat-augmented latissimus dorsi myocutaneous flap can overcome the volume insufficiency of latissimus dorsi flaps by immediate fat grafting into the flap. When breast skin supplementation is unnecessary, latissimus dorsi flaps can be harvested as a muscle flap to avoid an additional back incision. Here, we compared the efficacy of fat-augmented latissimus dorsi myocutaneous and muscle flaps in total breast reconstruction. We retrospectively reviewed 94 cases of unilateral total breast reconstruction using fat-augmented latissimus dorsi flaps (muscle: 40, myocutaneous: 54) at our hospital from September 2017 to March 2022. The muscle flap group had a significantly shorter operative time than the myocutaneous flap group (p |
| doi_str_mv | 10.1016/j.bjps.2023.04.081 |
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When breast skin supplementation is unnecessary, latissimus dorsi flaps can be harvested as a muscle flap to avoid an additional back incision. Here, we compared the efficacy of fat-augmented latissimus dorsi myocutaneous and muscle flaps in total breast reconstruction. We retrospectively reviewed 94 cases of unilateral total breast reconstruction using fat-augmented latissimus dorsi flaps (muscle: 40, myocutaneous: 54) at our hospital from September 2017 to March 2022. The muscle flap group had a significantly shorter operative time than the myocutaneous flap group (p < 0.0001). Mastectomy specimen weight did not differ between the 2 groups, but total flap weight in the muscle flap group was significantly lower (p < 0.0001). Conversely, total fat graft volume, fat graft volume to the latissimus dorsi flap, and fat graft volume to the pectoralis major muscle were significantly greater in the muscle flap group (p < 0.0001, p < 0.0001, and p = 0.02, respectively). The percentage of cases requiring additional fat grafting was significantly higher in the muscle flap group, but postoperative esthetic evaluation did not significantly differ between the 2 groups. Both groups scored high on each BREAST-Q item, but the muscle flap group scored significantly higher for “Satisfaction with Back.” Although the frequency of additional fat grafting was higher than with fat-augmented latissimus dorsi myocutaneous flaps, total breast reconstruction with fat-augmented latissimus dorsi muscle flaps is a viable technique with a short operative time and high patient satisfaction.</description><identifier>ISSN: 1748-6815</identifier><identifier>EISSN: 1878-0539</identifier><identifier>DOI: 10.1016/j.bjps.2023.04.081</identifier><identifier>PMID: 37279635</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Autologous reconstruction ; Breast Neoplasms - surgery ; Fat graft ; Fat transfer ; Female ; Humans ; Lipofilling ; Lipoinjection ; Mammaplasty - methods ; Mastectomy ; Myocutaneous Flap ; Retrospective Studies ; Scarless ; Superficial Back Muscles - transplantation ; Treatment Outcome</subject><ispartof>Journal of plastic, reconstructive & aesthetic surgery, 2023-08, Vol.83, p.250-257</ispartof><rights>2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons</rights><rights>Copyright © 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. 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When breast skin supplementation is unnecessary, latissimus dorsi flaps can be harvested as a muscle flap to avoid an additional back incision. Here, we compared the efficacy of fat-augmented latissimus dorsi myocutaneous and muscle flaps in total breast reconstruction. We retrospectively reviewed 94 cases of unilateral total breast reconstruction using fat-augmented latissimus dorsi flaps (muscle: 40, myocutaneous: 54) at our hospital from September 2017 to March 2022. The muscle flap group had a significantly shorter operative time than the myocutaneous flap group (p < 0.0001). Mastectomy specimen weight did not differ between the 2 groups, but total flap weight in the muscle flap group was significantly lower (p < 0.0001). Conversely, total fat graft volume, fat graft volume to the latissimus dorsi flap, and fat graft volume to the pectoralis major muscle were significantly greater in the muscle flap group (p < 0.0001, p < 0.0001, and p = 0.02, respectively). The percentage of cases requiring additional fat grafting was significantly higher in the muscle flap group, but postoperative esthetic evaluation did not significantly differ between the 2 groups. Both groups scored high on each BREAST-Q item, but the muscle flap group scored significantly higher for “Satisfaction with Back.” Although the frequency of additional fat grafting was higher than with fat-augmented latissimus dorsi myocutaneous flaps, total breast reconstruction with fat-augmented latissimus dorsi muscle flaps is a viable technique with a short operative time and high patient satisfaction.</description><subject>Autologous reconstruction</subject><subject>Breast Neoplasms - surgery</subject><subject>Fat graft</subject><subject>Fat transfer</subject><subject>Female</subject><subject>Humans</subject><subject>Lipofilling</subject><subject>Lipoinjection</subject><subject>Mammaplasty - methods</subject><subject>Mastectomy</subject><subject>Myocutaneous Flap</subject><subject>Retrospective Studies</subject><subject>Scarless</subject><subject>Superficial Back Muscles - transplantation</subject><subject>Treatment Outcome</subject><issn>1748-6815</issn><issn>1878-0539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtv3CAURlHVqHm0fyCLiGU3dnjYBqJuoqh5SJGySdeIgUvLyDYO4ESz7D8vo0m77Iorcb5P9x6EzilpKaHD5bbdbJfcMsJ4S7qWSPoBnVApZEN6rj7WWXSyGSTtj9FpzltCOk67_hM65oIJNfD-BP1-jsWMeJPA5IIT2DjnklZbQpzxWyi_sMHelMasPyeYCzg8mhJyDtOasYspB-xHs1zha2zjtJhUf18B57K6Hd5AeQOYcWXtCNjMDk-7aNdiZog1v0_mz-jImzHDl_f3DP24_f58c988Pt093Fw_Npb3Q2mcsuA6A5JzTr2QRjHlrQKvJJFMeiascwCD54w52w9W9d4SKayXA6fG8zP09dC7pPiyQi56CtnCOB6W0Uwy3imhOlFRdkBtijkn8HpJYTJppynRe_V6q_fq9V69Jp2u6mvo4r1_3Uzg_kX-uq7AtwMA9crXAElnG2CuZ4XqvWgXw__6_wCElZkh</recordid><startdate>202308</startdate><enddate>202308</enddate><creator>Tomita, Koichi</creator><creator>Taminato, Mifue</creator><creator>Kubo, Tateki</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202308</creationdate><title>Total breast reconstruction with a fat-augmented latissimus dorsi flap: A comparative study between muscle and myocutaneous flaps</title><author>Tomita, Koichi ; Taminato, Mifue ; Kubo, Tateki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-d9ced4ae83331f78a929fc9ef980828f27cddee6f322dc56c95fc087cf8631af3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Autologous reconstruction</topic><topic>Breast Neoplasms - surgery</topic><topic>Fat graft</topic><topic>Fat transfer</topic><topic>Female</topic><topic>Humans</topic><topic>Lipofilling</topic><topic>Lipoinjection</topic><topic>Mammaplasty - methods</topic><topic>Mastectomy</topic><topic>Myocutaneous Flap</topic><topic>Retrospective Studies</topic><topic>Scarless</topic><topic>Superficial Back Muscles - transplantation</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tomita, Koichi</creatorcontrib><creatorcontrib>Taminato, Mifue</creatorcontrib><creatorcontrib>Kubo, Tateki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tomita, Koichi</au><au>Taminato, Mifue</au><au>Kubo, Tateki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Total breast reconstruction with a fat-augmented latissimus dorsi flap: A comparative study between muscle and myocutaneous flaps</atitle><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle><addtitle>J Plast Reconstr Aesthet Surg</addtitle><date>2023-08</date><risdate>2023</risdate><volume>83</volume><spage>250</spage><epage>257</epage><pages>250-257</pages><issn>1748-6815</issn><eissn>1878-0539</eissn><abstract>The fat-augmented latissimus dorsi myocutaneous flap can overcome the volume insufficiency of latissimus dorsi flaps by immediate fat grafting into the flap. When breast skin supplementation is unnecessary, latissimus dorsi flaps can be harvested as a muscle flap to avoid an additional back incision. Here, we compared the efficacy of fat-augmented latissimus dorsi myocutaneous and muscle flaps in total breast reconstruction. We retrospectively reviewed 94 cases of unilateral total breast reconstruction using fat-augmented latissimus dorsi flaps (muscle: 40, myocutaneous: 54) at our hospital from September 2017 to March 2022. The muscle flap group had a significantly shorter operative time than the myocutaneous flap group (p < 0.0001). Mastectomy specimen weight did not differ between the 2 groups, but total flap weight in the muscle flap group was significantly lower (p < 0.0001). Conversely, total fat graft volume, fat graft volume to the latissimus dorsi flap, and fat graft volume to the pectoralis major muscle were significantly greater in the muscle flap group (p < 0.0001, p < 0.0001, and p = 0.02, respectively). The percentage of cases requiring additional fat grafting was significantly higher in the muscle flap group, but postoperative esthetic evaluation did not significantly differ between the 2 groups. Both groups scored high on each BREAST-Q item, but the muscle flap group scored significantly higher for “Satisfaction with Back.” Although the frequency of additional fat grafting was higher than with fat-augmented latissimus dorsi myocutaneous flaps, total breast reconstruction with fat-augmented latissimus dorsi muscle flaps is a viable technique with a short operative time and high patient satisfaction.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>37279635</pmid><doi>10.1016/j.bjps.2023.04.081</doi><tpages>8</tpages></addata></record> |
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| ispartof | Journal of plastic, reconstructive & aesthetic surgery, 2023-08, Vol.83, p.250-257 |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Autologous reconstruction Breast Neoplasms - surgery Fat graft Fat transfer Female Humans Lipofilling Lipoinjection Mammaplasty - methods Mastectomy Myocutaneous Flap Retrospective Studies Scarless Superficial Back Muscles - transplantation Treatment Outcome |
| title | Total breast reconstruction with a fat-augmented latissimus dorsi flap: A comparative study between muscle and myocutaneous flaps |
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