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J Reconstr Microsurg 2022; 38(02): 129-136
DOI: 10.1055/s-0041-1731671
Original Article

Donor Site Morbidity after Lumbar Artery Perforator Flap Breast Reconstruction

Dries Opsomer 
1   Department of Plastic and Reconstructive Surgery, University of Gent, Belgium
2   Department of Plastic and Reconstructive Surgery, Onze Lieve Vrouwziekenhuis (OLV) Aalst, Belgium
,
Tom Vyncke
1   Department of Plastic and Reconstructive Surgery, University of Gent, Belgium
,
Michelle Ryx
1   Department of Plastic and Reconstructive Surgery, University of Gent, Belgium
,
Koenraad Van Landuyt
1   Department of Plastic and Reconstructive Surgery, University of Gent, Belgium
,
Phillip Blondeel
1   Department of Plastic and Reconstructive Surgery, University of Gent, Belgium
,
Filip Stillaert
1   Department of Plastic and Reconstructive Surgery, University of Gent, Belgium
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Abstract

Background The lumbar artery perforator flap is a second-choice flap in autologous breast reconstruction whenever a deep inferior epigastric artery perforator (DIEP) flap is not possible. Ideal candidates are pear-shaped women who do not have enough bulk on the abdomen or thighs. Patient-reported “satisfaction with breasts” is excellent but we were curious about the donor site morbidity.

Methods We performed a retrospective study of all lumbar flap breast reconstructions performed between 2010 and 2019. Patients were invited by e-mail and telephone to take part in a BREAST-Q survey.

Results One hundred fifty-four flaps were performed in 110 patients. Sixty-three patients filled out the BREAST-Q questionnaire. The most frequently observed donor site complications are seroma (35.1%), dehiscence (8.4%), and hematoma (3.2%). Correction of the donor site scar was performed in 31.8% of patients, lipofilling of the donor flank in 5.2%, and liposuction of the contralateral flank in 18.3% of patients. Body mass index (BMI) was the only significant risk factor for donor site complications. Patient-reported “satisfaction with donor site appearance” was good but significantly lower for primary reconstructions compared with secondary and tertiary procedures. Flap weight significantly influences patient-reported “physical wellbeing of the donor site.” Ninety-seven percent of patients would recommend the surgery to someone in a similar position and would do it all over.

Conclusion The lumbar artery perforator flap is a good alternative for breast reconstruction in selected patients. The donor site issues consist mainly of seromas, prolonged discomfort, and a scar that might be noticeable to others, but patient-reported satisfaction is very high.

Keywords

lumbar artery perforator flap - autologous breast reconstruction - donor site


Publication History

Received: 01 February 2021

Accepted: 12 May 2021

Article published online:
23 August 2021

© 2021. Thieme. All rights reserved.

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333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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