Safety of a Modified Lipoabdominoplasty Technique for Donor-Site Closure in Abdominal-Based Free Flap Breast Reconstruction

Abstract

Background

The aesthetic and functional outcomes of the donor site following abdominal-based free flap breast reconstruction have been suboptimal. The objective of this study is to evaluate a modified liposuction-assisted abdominoplasty technique combined with rectus plication (LPARSP) adopted from cosmetic abdominoplasty practice.

Patients and Methods

All abdominal-based free flap breast reconstructions from 01/2017 to 03/2019 were reviewed. Patients with central fullness and sufficient tissue surplus on the abdomen, thighs and flanks who received LPARSP and rectus plication were identified (LPARSP group) and matched for age and body mass index with patients who underwent conventional abdominoplasty (CA group). Abdominal skin sensation, objective functional and aesthetic measures of the abdomen, as well as patient-reported outcomes (Breast-Q), were analyzed.

Results

A total of 28 patients were included. Groups were similar in demographics. The mean amount of lipoaspirate in the LPARSP group was 1054±613.5 ml. The postoperative course was similar in both groups. The LPARSP technique resulted in a lower positioned horizontal scar (p = 0.03). The aesthetic outcome was superior in the LPARSP group (p < 0.0001). Furthermore, the LPARSP group presented with a decreased bulging rate (p = 0.05), and secondary refinement procedures were less frequently demanded (p = 0.02). In addition, the abdominal wall sensation of the flanks was improved in the LPARSP group (p = 0.05), whereby patient-reported outcome measures did not differ between groups.

Conclusions

Lipoabdominoplasty with rectus plication represents a safe approach for donor-site closure in selected patients undergoing abdominal-based free flap breast reconstruction. Superior functional and aesthetic results paired with improved abdominal wall sensation are achieved compared to CA.

Level of Evidence IV

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Funding

No funding was received.

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Affiliations

Authors

Contributions

All authors made substantial contributions. DKF designed the study. DKF, LS and SF acquired all data. CH, UK and SM interpreted and analyzed the data. DKF, LS and SF drafted the article. SM, CH and UK critically revised the manuscript.

Corresponding author

Correspondence to Dimitra Kotsougiani-Fischer.

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Conflict of interest

The authors have no conflict of interest to declare. There was no external funding source for this study.

Ethical Approval

Institutional review board approval [837.516.16 (10834)] was obtained, and the study was designed in accordance with the ethical standards laid down in the 1975 World Medical Association Declaration of Helsinki and its later amendments.

Informed Consent

Written informed consent was obtained from all participants.

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Kotsougiani-Fischer, D., Sieber, L., Fischer, S. et al. Safety of a Modified Lipoabdominoplasty Technique for Donor-Site Closure in Abdominal-Based Free Flap Breast Reconstruction. Aesth Plast Surg (2021). https://doi.org/10.1007/s00266-020-02117-y

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Keywords

  • Breast reconstruction
  • Donor-site
  • Abdominal-based free flap
  • Refinement procedure
  • Satisfaction
  • Sensation
  • Abdominoplasty
  • Liposuction
  • Rectus sheath plication