Abstract
Purpose The dual-plane deep inferior epigastric perforator (DIEP) flap inset technique is
herein presented with tips for optimizing the aesthetic outcome in delayed autologous
breast reconstruction after radiation therapy.
Patients and Methods A total of 42 women who underwent microsurgical reconstruction with a free DIEP flap
participated in this prospective study. The flap was inset in a dual plane lying behind
the pectoralis major at the upper pole and in front of the muscle at the lower pole
of the reconstructed breast.
Results The dual-plane flap inset resulted in natural transition from native and reconstructed
tissues, excellent scar quality, optimal outline of the breast, and overall breast
appearance. Moreover, dual-plane reconstruction was associated with constantly high
patient satisfaction without wearing brassiere due to fullness of the upper pole and
minimal ptosis with time.
Conclusion The dual-plane DIEP flap inset results in optimal scar quality, breast shape, and
fullness of the upper pole, resulting in high patient satisfaction.
Keywords
irradiated breast - aesthetic subunit - DIEP flap - flap inset - dual plane
