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Revista chilena de cirugía

versión On-line ISSN 0718-4026

Resumen

MARRE, Diego; GANTZ, José Tomás; HONTANILLA, Bernardo  y  AUBA, Cristina. Tertiary breast reconstruction with autologous tissue after failed reconstruction with implants. Rev Chil Cir [online]. 2016, vol.68, n.6, pp.433-439. ISSN 0718-4026.  http://dx.doi.org/10.1016/j.rchic.2016.04.004.

Objective: Analyze our experience on tertiary breast reconstruction after failed implant-based procedures. Methods: Between 2005 and 2014, the authors (BH and CA) performed tertiary breast reconstruction with the deep inferior epigastric artery perforator flap (DIEP) flap in 17 cases. The medical charts of these patients were retrospectively reviewed, registering age at tertiary reconstruction, comorbidities, body mass index (BMI), presence of abdominal scars and history of radiotherapy and chemotherapy. Likewise, details from surgeries were also gathered, both form the implant-based procedures and tertiary autologous reconstruction. Results: Complications motivating the change of reconstructive strategy included capsular contracture, implant rupture, implant exposure/infection, chronic pain and failure of skin expansion. Regarding tertiary reconstruction, the DIEP flap was used in all cases with one partial flap loss and no total failures. Conclusions: Current options for autologous tertiary reconstruction include mainly perforator flaps with the DIEP being by far the most utilized. Additionally, tertiary reconstruction is a safe procedure, with a rate of complications similar to that of primary and secondary free flap breast reconstruction.

Palabras clave : Deep inferior epigastric artery perforator flap; Breast reconstruction; Breast implants; Tertiary breast reconstruction; Radiotherapy.

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