Work

Salvage of a failed partial prosthetic breast reconstruction using a free deep inferior epigastric artery perforator (DIEP) flap

Year: 2025

Type: article

Abstract: Tertiary breast reconstruction with free tissue transfers is the gold standard in managing recalcitrant complications of implant-based whole breast reconstructions (WBRs). Whilst the salvage of implant-based WBR with free tissue transfers is well established, there have hitherto been no reports of free flap use for salvaging failed or suboptimal partial prosthetic breast reconstructions. We report a case of delayed partial breast reconstruction after lumpectomy and axillary clearance, where a deep inferior epigastric artery perforator flap successfully salvaged a suboptimal thoracodorsal artery perforator flap (TDAP) with underlying peri-implant capsular contracture, avoiding the need for completion mastectomy. The challenges encountered were complicated by severe capsular contracture, chronic pain, poor cosmesis, prior tissue rearrangement, radiotherapy changes, residual breast tissue, and scarring from a previous TDAP flap. Microvascular autologous conversion, a standard treatment of failed prosthetic WBRs, also has the versatility to salvage complex partial reconstructive dilemmas accentuated by prior radiotherapy and the presence of residual potentially compromised breast tissue.

Source: Journal of Surgical Case Reports

DOI: 10.1093/jscr/rjaf888

Authors: Christopher Cherian, Sarah Omar, Krzysztof Sosnowski, Chloe Jordan, Charles Malata

Institutions: Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, University of Cambridge, Anglia Ruskin University

Language: English

Topic: Breast Implant and Reconstruction

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,000