Body lift perforator flap breast reconstruction: a review of 100 flaps in 25 cases.

BACKGROUND Advances in autologous breast reconstruction continue to mount and have been fueled most substantially with refinement of perforator flap techniques. METHODS For patients with a desire for autogenous breast reconstruction and insufficient abdominal fat for conventional abdominal flaps, secondary options such as gluteal perforator flaps or latissimus flaps are usually considered. Patients who also have insufficient soft tissue in the gluteal donor site and preference to avoid an implant, present a vexing problem. The authors describe an option that allows for incorporation of four independent perforator flaps for bilateral breast reconstruction when individual donor sites are too thin to provide necessary volume. The authors present their experience with this technique in 25 patients with 100 individual flaps over 5 years. RESULTS The body lift perforator flap technique, using a layered deep inferior epigastric perforator/gluteal perforator flap combination for each breast, was performed in this patient set with high success rates and quality aesthetic outcomes over several years. Patient satisfaction was high among the studied population. CONCLUSIONS The body lift perforator flap breast reconstruction technique can be a reliable, safe, but technically demanding solution for patients seeking autogenous breast reconstruction with otherwise inadequate individual fatty donor sites. This sophisticated procedure overcomes a limitation of autogenous breast reconstruction for these patients that otherwise results in a breast with poor projection and overall volume insufficiency. The harvest of truncal fat with a circumferential body lift design gives the potential added benefit of improved body contour as a complement to this powerful breast reconstructive technique. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.