Purpose Statement

With the advent of perforator flaps, breast reconstruction options now include DIEP, S-GAP, and I-GAP flaps. However, implant reconstruction was utilized in approximately 80% of 57,778 reconstruction cases in 2005. Many patients present with complaints of inferior aesthetic results and pain. These implant failures or tertiary reconstructions account for 26% of cases done over a two year period.

Methods and Materials

All flaps performed by the senior surgeon were reviewed over a two year period. Three hundred and fifty-five flaps were performed during that period with 91 flaps being tertiary reconstructions. A chart review was performed comparing these patient populations.

Summary of Results/Conclusions

Approximately 70% of tertiary reconstructions were performed with abdominal perforator flaps and 30% with gluteal perforator flaps. Patient Timing of tertiary reconstruction varies between several months to several years, and 12% of patients had undergone radiation therapy. After tertiary reconstruction patients had improved pain and cosmetic results, as well as improved self confidence.