Bilateral simultaneous breast reconstruction with SGAP flaps

Jaime I. Flores, Michael Magarakis, Raghunandan Venkat, Sachin M. Shridharani, Gedge David Rosson

Research output: Contribution to journalArticle

Abstract

Background: Two work-horse approaches to postmastectomy breast reconstruction are the deep inferior epigastric perforator flap and the superior gluteal artery perforator (SGAP) flap [and its variation, the lateral septocutaneous superior gluteal artery perforator flap]. Our purpose was fourfold: 1) to analyze our experience with the SGAP flaps for simultaneous bilateral breast reconstruction; 2) to analyze our experience with lateral septocutaneous superior gluteal artery perforator flaps for that procedure; 3) to compare our results with those in the literature; and 4) to highlight the importance of preoperative three-dimensional computed tomographic angiography. Methods: A retrospective chart review was completed for 23 patients who underwent breast reconstruction between December 2005 and January 2010 via an SGAP flap (46 flaps). We reviewed flap weight, ischemia time, length of stay, overall flap survival, fat necrosis development, and emergency re-exploration. Results: Mean weights were 571.2 ± 222.0 g (range 186-1,117 g) and 568.0 ± 237.5 g (range 209-1,115 g) for the left and right buttock flap, respectively. Mean ischemia time was 129.1 ± 15.7 and 177.7 ± 24.7 minutes for the first and second flap, respectively. Mean hospital stay was 5.3 ± 2.5 days. All flaps survived. Fat necrosis developed in five flaps (10.8%), and emergency re-exploration was required in three patients (three flaps). Conclusions: When harvesting abdominal tissue is a poor option, the SGAP flap is an efficacious procedure for patients desiring autologous breast reconstruction, and bilateral procedures can be performed simultaneously.

Original languageEnglish (US)
Pages (from-to)344-350
Number of pages7
JournalMicrosurgery
Volume32
Issue number5
DOIs
StatePublished - Jul 2012

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Perforator Flap
Mammaplasty
Arteries
Fat Necrosis
Length of Stay
Emergencies
Ischemia
Tissue and Organ Harvesting
Weights and Measures
Buttocks
Horses
Angiography
Survival

ASJC Scopus subject areas

  • Surgery

Cite this

Flores, J. I., Magarakis, M., Venkat, R., Shridharani, S. M., & Rosson, G. D. (2012). Bilateral simultaneous breast reconstruction with SGAP flaps. Microsurgery, 32(5), 344-350. https://doi.org/10.1002/micr.21953

Bilateral simultaneous breast reconstruction with SGAP flaps. / Flores, Jaime I.; Magarakis, Michael; Venkat, Raghunandan; Shridharani, Sachin M.; Rosson, Gedge David.

In: Microsurgery, Vol. 32, No. 5, 07.2012, p. 344-350.

Research output: Contribution to journalArticle

Flores, JI, Magarakis, M, Venkat, R, Shridharani, SM & Rosson, GD 2012, 'Bilateral simultaneous breast reconstruction with SGAP flaps', Microsurgery, vol. 32, no. 5, pp. 344-350. https://doi.org/10.1002/micr.21953
Flores JI, Magarakis M, Venkat R, Shridharani SM, Rosson GD. Bilateral simultaneous breast reconstruction with SGAP flaps. Microsurgery. 2012 Jul;32(5):344-350. https://doi.org/10.1002/micr.21953
Flores, Jaime I. ; Magarakis, Michael ; Venkat, Raghunandan ; Shridharani, Sachin M. ; Rosson, Gedge David. / Bilateral simultaneous breast reconstruction with SGAP flaps. In: Microsurgery. 2012 ; Vol. 32, No. 5. pp. 344-350.
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N2 - Background: Two work-horse approaches to postmastectomy breast reconstruction are the deep inferior epigastric perforator flap and the superior gluteal artery perforator (SGAP) flap [and its variation, the lateral septocutaneous superior gluteal artery perforator flap]. Our purpose was fourfold: 1) to analyze our experience with the SGAP flaps for simultaneous bilateral breast reconstruction; 2) to analyze our experience with lateral septocutaneous superior gluteal artery perforator flaps for that procedure; 3) to compare our results with those in the literature; and 4) to highlight the importance of preoperative three-dimensional computed tomographic angiography. Methods: A retrospective chart review was completed for 23 patients who underwent breast reconstruction between December 2005 and January 2010 via an SGAP flap (46 flaps). We reviewed flap weight, ischemia time, length of stay, overall flap survival, fat necrosis development, and emergency re-exploration. Results: Mean weights were 571.2 ± 222.0 g (range 186-1,117 g) and 568.0 ± 237.5 g (range 209-1,115 g) for the left and right buttock flap, respectively. Mean ischemia time was 129.1 ± 15.7 and 177.7 ± 24.7 minutes for the first and second flap, respectively. Mean hospital stay was 5.3 ± 2.5 days. All flaps survived. Fat necrosis developed in five flaps (10.8%), and emergency re-exploration was required in three patients (three flaps). Conclusions: When harvesting abdominal tissue is a poor option, the SGAP flap is an efficacious procedure for patients desiring autologous breast reconstruction, and bilateral procedures can be performed simultaneously.

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