EP 583 Tripedicle NSM in Combination with Extended TDAP Flap for Total Breast Reconstruction
Khaled E Barakat, Ahmed Abdullatif Abdelkader, Mohamed F AsalAbstract
Aim
To describe the surgical outcomes, feasibility, and patient-reported satisfaction following TP-NSSRM (Tripedicle-Nipple Sparing Skin Reducing Mastectomy) combined with extended TDAP flap for total breast reconstruction.
Methods
We prospectively evaluated 45 patients who underwent TP-NSSRM combined with extended TDAP flap reconstruction. Patient demographics, oncological characteristics, operative parameters, and postoperative outcomes were recorded. Operation time, intraoperative bleeding, flap survival, aesthetic outcomes, patient satisfaction, and complications were analyzed.
Result
The mean operation time was 182.8 ± 28.6 minutes. Mean intraoperative bleeding was 242.3 ± 36.5 ml. The mean drainage per day was 86.7 ± 24.2 ml with mean duration till drain removal of 4.18 ± 0.92 days. Complete flap survival was achieved in 44 patients (97.8%), with one case of partial flap necrosis requiring debridement and secondary reconstruction. Nipple-areola complex necrosis occurred in 2 patients (4.4%), managed conservatively. Minor complications included seroma formation in 3 patients (6.7%) and wound dehiscence in 2 patients (4.4%). No major complications such as hematoma requiring reoperation or complete flap loss were observed. Patient satisfaction scores at 6 months showed excellent results in 38 patients (84.4%), good results in 6 patients (13.3%), and fair results in 1 patient (2.2%).
Conclusion
TP-NSSRM combined with extended TDAP flap is a safe and effective technique for total autologous breast reconstruction in patients with large and ptotic breasts. This approach demonstrates high flap survival rates, low complication rates, and excellent patient satisfaction. The technique provides adequate volume replacement without implants, making it particularly suitable for patients requiring post-mastectomy radiotherapy or those preferring autologous reconstruction.