Breast reconstruction with DIEP flap in a patient with acquired amastia.
Clinical case report.
DOI:
https://doi.org/10.31837/cir.urug/10.1.1Keywords:
breast reconstruction, amastia, free flap, DIEPAbstract
Introduction: Microvascular breast reconstruction is a fundamental component in the comprehensive therapeutic management of patients with congenital or acquired conditions that severely affect the anatomy and function of the breast. This challenge becomes even more complex when amastia results from traumatic events or severe skin and soft tissue infections.
Objective: To present an unusual clinical case of amastia secondary to a severe neonatal skin and soft tissue infection, and to highlight the reconstructive approach used, with an emphasis on its therapeutic value.
Materials and Methods: We report the case of an adult female patient with acquired amastia as a sequela of an infectious process of the trunk during the neonatal period. The treatment involved breast reconstruction using a deep inferior epigastric artery perforator (DIEP) free flap, followed by contralateral symmetrization.
Discussion and Conclusions: This case underscores the importance of individualized planning and surgical expertise in complex breast reconstruction, contributing to both the physical and psychological well-being of patients affected by this rare condition.
Downloads
References
Dagnino UB. Actualización en reconstrucción mamaria. Rev Med Clin Condes. 2010;21(1):51–5. doi:10.1016/S0716-8640(10)70506-X.
Fernández Toledo E, Gómez García N, Machado Gómez G, Santana Molina R, Suárez Morales O, Madrigal Mora L. Infecciones graves de piel y partes blandas. Acta Méd Centro.2023;17(4):681-93.
Carr RJ, Smith SM, Peters SB. Primary and secondary dermatologic disorders of the breast. En: Bland KI, Copeland EM, Klimberg VS, Gradishar WJ, editors. The Breast: Comprehensive Management of Benign and Malignant Diseases. 5a. ed. Philadelphia: Elsevier; 2018. p. 269–86.
Rincón Fernández ME, Pérez San Gregorio MA, Borda Más M, Rodríguez AM. Impacto de la reconstrucción mamaria sobre la autoestima y la imagen corporal en pacientes con cáncer de mama. Universitas Psychologica. 2012;11(1):25–41. doi:10.11144/Javeriana.upsy11-1.irma
Fossati JM, Fraga L, Ripoll G, Wolff D, Fossati G. Reconstrucción mamaria con colgajo perforante de arteria epigástrica inferior profunda (DIEP). Rev Argent Cir Plást. 2017;23(2):49-54.
Más M, Tórtora S, Morosini F, Hernández K, Benítez MA, Dall´Orso P, et. al. Infecciones de piel y partes blandas tratadas en forma ambulatoria en un hospital pediátrico en Uruguay luego de diez años de la epidemia de SAMR. Arch Pediatr Urug. 2018;89(4):251-256. doi: 10.31134/ap.89.4.4
Koshima I, Soeda S. Inferior epigastric artery skin flaps without rectus abdominis muscle. Br J Plast Surg. 1989;42(6):645-8. doi: 10.1016/0007-1226(89)90075-1
Teunis T, Heerma van Voss MR, Kon M, van Maurik JF. CT-angiography prior to DIEP flap breast reconstruction: a systematic review and meta-analysis. Microsurgery. 2013;33(6):496-502. doi: 10.1002/micr.22119.
Rothenberger J, Amr A, Schiefer J, Schaller HE, Rahmanian-Schwarz A. A quantitative analysis of the venous outflow of the deep inferior epigastric flap (DIEP) based on the perforator veins and the efficiency of superficial inferior epigastric vein (SIEV) supercharging. J Plast Reconstr Aesthet Surg. 2013;66(1):67-72. doi: 10.1016/j.bjps.2012.08.020.
Colás C, Lozano JA, Pelay MJ. Reconstrucción mamaria mediante el colgajo musculocutáneo del dorsal ancho. Anales Sis San Navarra. 2005; 28(Suppl 2):55-61.
Gagnon AR, Blondeel PN. Superior Gluteal Artery Perforator Flap. Semin Plast Surg. 2006;20(2):79–88. doi: 10.1055/s-2006-941714.
Vonu PM, Chopan M, Sayadi L, Chim HW, Leyngold M. Lumbar Artery Perforator Flaps: A Systematic Review of Free Tissue Transfers and Anatomical Characteristics. Ann Plast Surg. 2022;89(4):465-471. doi: 10.1097/SAP.0000000000003216.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Marcos Garrel, Liber Fraga, Daniel Wolff, Camilo Prego
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles, videos and images published in Revista Cirugía del Uruguay are under the Creative Commons CC licenses, which is a complement to the traditional copyright, in the following terms: first, the authorship of the referred document must always be acknowledged and secondly none of the article or work published in the journal may have commercial purposes of any nature. The authors retain their copyrights and give the magazine the right of first publication of their work, which will be simultaneously subject to the Creative Commons Attribution-NonCommercial 4.0 International License license that allows the work to be shared whenever the initial publication is indicated in this journal.
