Constantine Ryan S, Foppiani Jose A, Allenby Taylor, Kokosis George, Mathes David W, Winocour Julian, Kaoutzanis Christodoulos
Division of Plastic and Reconstructive Surgery, University of Colorado Anschutz Medical Campus, 12631 East 17th Avenue, Mail Stop C309, Aurora, CO, 80045, USA.
Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Aesthetic Plast Surg. 2025 Jan;49(1):164-168. doi: 10.1007/s00266-024-04228-2. Epub 2024 Jul 11.
The purse-string DIEPplasty technique is a method to improve aesthetic outcomes in breast reconstruction using deep inferior epigastric perforator (DIEP) free flaps. Traditionally, DIEP flaps, harvested from the lower abdomen, take on a triangular shape that can lead to sub-optimal aesthetic outcomes with occasionally poor breast projection, irregular contours, or minimal upper pole fullness. The purse-string DIEPplasty technique addresses these issues by using a 0 Polydioxanone continuous purse-string suture through the Scarpa's fascia to modify the harvested flap's shape before inset, giving it a more round base and a central dome-like projection similar to an implant. This method mimics the shape of a breast implant, enhancing the flap's projection, volumetric efficiency, and overall shape, leading to a reconstructed breast with improved aesthetic qualities. This technique represents a potential advancement in reconstructive breast surgery, aiming to reduce the extent of revision procedures and improve patient satisfaction. Further research, however, is needed to validate its effectiveness over time and assess potential complications.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
荷包缝合法腹壁下动脉穿支皮瓣成形术是一种利用腹壁下深动脉穿支（DIEP）游离皮瓣改善乳房重建美学效果的方法。传统上，从下腹部切取的DIEP皮瓣呈三角形，可能导致美学效果欠佳，偶尔会出现乳房突出不足、轮廓不规则或上极饱满度欠佳的情况。荷包缝合法腹壁下动脉穿支皮瓣成形术通过使用一根0号聚二氧六环酮连续荷包缝线穿过斯卡帕筋膜，在植入前改变切取皮瓣的形状，使其具有更圆润的基底和类似植入物的中央穹顶样突出，从而解决这些问题。该方法模仿了乳房植入物的形状，增强了皮瓣的突出度、容积效率和整体形状，使重建后的乳房具有更好的美学质量。这项技术代表了乳房重建手术的一项潜在进展，旨在减少修复手术的范围并提高患者满意度。然而，需要进一步研究来验证其长期有效性并评估潜在并发症。证据等级IV 本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述，请参阅目录或在线作者指南www.springer.com/00266 。
