Journal of reconstructive microsurgery | 2021
Donor Site Morbidity after Lumbar Artery Perforator Flap Breast Reconstruction.
Abstract
BACKGROUND\n\u2003The 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.\n\n\nMETHODS\n\u2003We 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.\n\n\nRESULTS\n\u2003One 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.\n\n\nCONCLUSION\n\u2003The 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.