Achieving an aesthetic abdomen in DIEP flap breast reconstruction: Our experience

BACKGROUND: Deep Inferior Epigastric Artery Perforator (DIEP) Flap is regarded as a gold standard for autologous breast reconstruction. Authors have primarily focused on breast reconstruction and abdominal morbidity. Although scar quality and position are frequent complaints of patients, little attention has been paid to abdominal aesthetic outcomes. Here, we present a two-step integrated surgical protocol to enhance the aesthetic results of the abdomen without compromising breast reconstruction. METHODS: This is a retrospective series of 136 patients who underwent a DIEP breast reconstruction according to this protocol. Population characteristics, as well as outcomes, were studied. Patient satisfaction and well being were assessed using post-operative reconstructive modules of the BREAST-Q 2.0 questionnaire. RESULTS: In all cases, the abdominal scar could be lowered to be concealed under women's undergarments. Low morbidity rates were recorded, and no abdominal complications were observed after the second procedure. Sixty-eight patients responded to the BREAST-Q questionnaire with high scores. CONCLUSION: This is the first integrated surgical protocol in which the overall aesthetic improvement is considered throughout the reconstruction process. The technique has proved safe and effective in providing women with a pleasing abdomen after DIEP flap breast reconstruction.