DOI QR코드

DOI QR Code

The Impact of Abdominal Liposuction on Abdominally Based Autologous Breast Reconstruction: A Systematic Review

  • Bond, Evalina S. (Division of Plastic Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health) ;
  • Soteropulos, Carol E. (Division of Plastic Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health) ;
  • Poore, Samuel O. (Division of Plastic Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health)
  • Published : 2022.05.15

Abstract

Prior abdominal liposuction can be viewed as a relative or absolute contraindication to abdominally based autologous breast reconstruction given concerns for damaged perforators and scarring complicating intraoperative dissection. This systematic review aims to explore the outcomes of abdominally based breast reconstruction in patients with a history of abdominal liposuction. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided literature search was conducted using PubMed, Scopus, and Web of Science from the earliest available date through June 2020. Deep inferior epigastric perforator, muscle-sparing transverse rectus abdominis musculocutaneous (TRAM), superficial inferior epigastric artery, and pedicled TRAM flaps were included for evaluation. Complications included total or partial flap loss, fat necrosis, seroma, delayed wound healing, and donor site complications. After inclusion criteria were applied, 336 non-duplicate articles were screened, yielding 11 for final review, representing 55 flaps in 43 patients. There was no instance of total flap loss, eight (14.5%) flaps developed partial loss or fat necrosis, three (5.4%) flaps had delayed wound healing, and two (4.6%) patients had donor site complications. Most authors (8/11) utilized some type of preoperative imaging. Doppler ultrasonography was the most used modality, and these patients had the lowest rate of partial flap loss or flap fat necrosis (8%), followed by those without any preoperative imaging (10%). In conclusion, this review supports that patients undergoing abdominally based autologous breast reconstruction with a history of abdominal liposuction are not at an increased risk of flap or donor site complications. Although preoperative imaging was common, it did not reliably decrease complications. Further prospective studies are needed to address the role of imaging in improving outcomes.

Keywords

References

  1. Toyserkani NM, Jorgensen MG, Tabatabaeifar S, Damsgaard T, Sorensen JA. Autologous versus implant-based breast reconstruction: a systematic review and meta-analysis of Breast-Q patient-reported outcomes. J Plast Reconstr Aesthet Surg 2020;73(02):278-285 https://doi.org/10.1016/j.bjps.2019.09.040
  2. Eltahir Y, Krabbe-Timmerman IS, Sadok N, Werker PMN, de Bock GH. Outcome of quality of life for women undergoing autologous versus alloplastic breast reconstruction following mastectomy: a systematic review and meta-analysis. Plast Reconstr Surg 2020;145(05):1109-1123 https://doi.org/10.1097/PRS.0000000000006720
  3. Avashia YJ, Desrosiers AE III, Flores JI. A second superior gluteal artery perforator flap with previous liposuction to the same breast after resection of initial SGAP breast reconstruction due to cancer recurrence. Microsurgery 2012;32(06):482-484 https://doi.org/10.1002/micr.21989
  4. Godfrey PM, Godfrey NV. Transverse rectus abdominis musculocutaneous flaps after liposuction of the abdomen. Ann Plast Surg 1994;33(02):209-210 https://doi.org/10.1097/00000637-199408000-00015
  5. Hamdi M, Khuthaila DK, Van Landuyt K, Roche N, Monstrey S. Double-pedicle abdominal perforator free flaps for unilateral breast reconstruction: new horizons in microsurgical tissue transfer to the breast. J Plast Reconstr Aesthet Surg 2007;60(08):904-912 https://doi.org/10.1016/j.bjps.2007.02.016
  6. Jandali S, Nelson JA, Wu LC, Serletti JM. Free transverse rectus abdominis myocutaneous flap for breast reconstruction in patients with prior abdominal contouring procedures. J Reconstr Microsurg 2010;26(09):607-614 https://doi.org/10.1055/s-0030-1267377
  7. LoTempio MM, Allen RJ. Breast reconstruction with SGAP and IGAP flaps. Plast Reconstr Surg 2010;126(02):393-401 https://doi.org/10.1097/PRS.0b013e3181de236a
  8. Salgarello M, Barone-Adesi L, Cina A, Farallo E. The effect of liposuction on inferior epigastric perforator vessels: a prospective study with color Doppler sonography. Ann Plast Surg 2005;55(04):346-351 https://doi.org/10.1097/01.sap.0000179168.69667.43
  9. Hess CL, Gartside RL, Ganz JC. TRAM flap breast reconstruction after abdominal liposuction. Ann Plast Surg 2004;53(02):166-169 https://doi.org/10.1097/01.sap.0000112289.88210.32
  10. Zavlin D, Jubbal KT, Ellsworth WA IV, Spiegel AJ. Breast reconstruction with DIEP and SIEA flaps in patients with prior abdominal liposuction. Microsurgery 2018;38(04):413-418 https://doi.org/10.1002/micr.30218
  11. Saint-Cyr M, Shirvani A, Wong C. The transverse upper gracilis flap for breast reconstruction following liposuction of the thigh. Microsurgery 2010;30(08):636-638 https://doi.org/10.1002/micr.20814
  12. Bellini E, Grieco MP, Raposio E. A journey through liposuction and liposculture: Review. Review Ann Med Surg (Lond) 2017;24:53-60 https://doi.org/10.1016/j.amsu.2017.10.024
  13. Moher D, Liberati A, Tetzlaff J, Altman DGPRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6(07):e1000097 https://doi.org/10.1371/journal.pmed.1000097
  14. Wes AM, Cleveland E, Nelson JA, et al. Do prior abdominal surgeries increase complications in abdominally based breast reconstructions? Ann Plast Surg 2015;75(05):526-533 https://doi.org/10.1097/SAP.0000000000000161
  15. De Frene B, Van Landuyt K, Hamdi M, et al. Free DIEAP and SGAP flap breast reconstruction after abdominal/gluteal liposuction. J Plast Reconstr Aesthet Surg 2006;59(10):1031-1036 https://doi.org/10.1016/j.bjps.2006.04.004
  16. Farid M, Nicholson S, Kotwal A, Akali A. DIEP breast reconstruction following multiple abdominal liposuction procedures. Eplasty 2014;14:e47
  17. Karanas YL, Santoro TD, Da Lio AL, Shaw WW. Free TRAM flap breast reconstruction after abdominal liposuction. Plast Reconstr Surg 2003;112(07):1851-1854 https://doi.org/10.1097/01.PRS.0000091170.35655.03
  18. Kim JY, Chang DW, Temple C, Beahm EK, Robb GL. Free transverse rectus abdominis musculocutaneous flap breast reconstruction in patients with prior abdominal suction-assisted lipectomy. Plast Reconstr Surg 2004;113(03):28e-31e https://doi.org/10.1097/01.PRS.0000105631.84512.3B
  19. Casey WJ III, Connolly KA, Nanda A, Rebecca AM, Perdikis G, Smith AA. Indocyanine green laser angiography improves deep inferior epigastric perforator flap outcomes following abdominal suction lipectomy. Plast Reconstr Surg 2015;135(03):491e-497e https://doi.org/10.1097/PRS.0000000000000964
  20. May JW Jr, Silverman RP, Kaufman JA. Flap perfusion mapping: TRAM flap after abdominal suction-assisted lipectomy. Plast Reconstr Surg 1999;104(07):2278-2281 https://doi.org/10.1097/00006534-199912000-00057
  21. Inceoglu S, Ozdemir H, Inceoglu F, Demir H, Onal B, Celebi C. Investigation of the effect of liposuction on the perforator vessels using color Doppler ultrasonography. Eur J Plast Surg 1998;21(01):38-42 https://doi.org/10.1007/BF01152422
  22. Ribuffo D, Marcellino M, Barnett GR, Houseman ND, Scuderi N. Breast reconstruction with abdominal flaps after abdominoplasties. Plast Reconstr Surg 2001;108(06):1604-1608 https://doi.org/10.1097/00006534-200111000-00026
  23. Akdeniz Dogan ZD, Sacak B, Yalcin D, Pilanci O, Tuncer FB, Celebiler O Assessment of tissue perfusion following conventional liposuction of perforator-based abdominal flaps. Arch Plast Surg 2017;44(02):109-116 https://doi.org/10.5999/aps.2017.44.2.109
  24. Brauman D, van der Hulst RRWJ, van der Lei B. Liposuction assisted abdominoplasty: an enhanced abdominoplasty technique. Plast Reconstr Surg Glob Open 2018;6(09):e1940 https://doi.org/10.1097/GOX.0000000000001940
  25. Xia Y, Zhao J, Cao DS. Safety of lipoabdominoplasty versus abdominoplasty: a systematic review and meta-analysis. Aesthetic Plast Surg 2019;43(01):167-174 https://doi.org/10.1007/s00266-018-1270-3
  26. Khansa I, Momoh AO, Patel PP, Nguyen JT, Miller MJ, Lee BT. Fat necrosis in autologous abdomen-based breast reconstruction: a systematic review. Plast Reconstr Surg 2013;131(03):443-452 https://doi.org/10.1097/PRS.0b013e31827c6dc2