DIEP flap for breast reconstruction: Retrospective evaluation of patient satisfaction on abdominal results

Background: Although some papers have analyzed patient satisfaction after traditional abdominoplasty, studies that have specifically assessed patient satisfaction on abdominal reconstruction after deep inferior epigastric perforator (DIEP) surgery are lacking. Aim: The aim of this study was to assess satisfaction, specifically for abdominoplasty results, in patients who underwent breast reconstruction with a single DIEP flap. Methods: This retrospective study included 53 consecutive patients who underwent unilateral breast reconstruction with a DIEP flap. The patients were all clinically evaluated during a specific consultation and answered a satisfaction survey based on a four-point scale (unsatisfied, satisfied, happy, and very happy). Results: A total of 50 patients responded to the survey. The average age was 52.3 years. This study revealed that 52% of the patients were happy or very happy with the aesthetic result of their abdomen. A total of 34% of the patients confessed that they preferred their abdomen before surgery. A further analysis of the dissatisfied patients showed particular dissatisfaction with dog-ears (50%), residual abdominal overhang (18%), or the horizontal scar (12%). The average distance between the horizontal scar and vulvar anterior commissure was 10.6 cm. A total of 86% of the patients were happy or very happy with the preoperative counseling. Conclusions: The authors note the necessity to give detailed preoperative information to explain the final abdominal aesthetic result, which can be quite different from the patient's expectations. (C) 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.