Pre-operative predictive estimation of abdominal flap volume for breast reconstruction using ultrasound and an anthropometric method

Background: The abdominal flap has proven to be an optimal autologous option for breast reconstruction. However, the feasibility of breast reconstruction using an abdominal flap should be determined pre-operatively, especially in lean patients. In order to achieve optimal symmetry when using an abdominal flap for breast reconstruction, a specific amount of abdominal tissue is required and this should be estimated prior to surgery. Methods: Patients with unilateral modified radical mastectomies requesting delayed breast reconstruction had their abdominal flap volume measured pre-operatively using a measuring tape and ultrasound. Contralateral breast volume was also measured using magnetic resonance imaging and was compared to the abdominal flap volume. Additionally, body mass index was measured for every patient. A correlation between each patient’s body mass index, contralateral breast volume, and abdominal flap volume was calculated. Results: Twenty patients with a mean age of 39 years (range 26–49 years, SD 6) and a mean body mass index of 29 (range 23–35, SD 4) were included in this study. The mean breast volume was 620 cm3, and the mean abdominal flap volume was 770 cm3 (excluding zone IV). The mean breast volume to abdominal flap volume ratio (without zone IV) was 0.8. Conclusions: Our pre-operative measurements of breast volume, abdominal flap volume, and body mass index enabled us to establish a relationship between these variables and to determine the feasibility of surgery and the need for additional volume enhancement and breast symmetrization procedures in patients seeking breast reconstruction. Level of Evidence: Level IV, risk/prognostic study. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.