The free deep inferior epigastric artery perforator (DIEP) flap is the gold standard in autologous breast reconstruction. Asian patients often present with a smaller body mass index with relatively insufficient tissue. To restore appropriate symmetry, a larger flap inset ratio must be transferred. Supercharging of the second vein or inclusion of bilateral pedicle is commonly required. Current paradigm shifts in mastectomy has also resulted in more minimally invasive surgeries (MIS) espousing smaller lateral incisions, leading to a significant change in available recipient vessels. This study aimed to demonstrate our experience in changing strategies of DIEP flaps following the evolution of mastectomy techniques. Between October 2008 and March 2022, retrospective data was gathered for 278 patients who underwent breast reconstruction surgery utilizing DIEP flaps by a single plastic surgeon. These patients were divided into two distinct groups based on their operation dates, with November 2018 marking a pivotal moment when the first MIS was introduced.
Sex
FEMALE
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Endoscopy mastectomy
Timeframe: Post-operative day 0
Robotic mastectomy
Timeframe: Post-operative day 0
Incision
Timeframe: Post-operative day 0
Usage of SIEV
Timeframe: Post-operative day 0
Inclusion of bipedicle
Timeframe: Post-operative day 0
Location of recipient artery/vein
Timeframe: Post-operative day 0
Recipient artery/vein selection
Timeframe: Post-operative day 0