Breast Reconstruction With a Deep Inferior Epigastric Perforator Flap: Imaging Appearances of the Normal Flap and Common Complications
ABSTRACT OBJECTIVE: The purpose of this essay is to illustrate the normal imaging appearance of deep inferior epigastric perforator (DIEP) flap breast reconstruction and common postoperative complications. CONCLUSION: Familiarity with the anatomy and normal imaging appearance of a DIEP flap reconstruction will help the breast imager recognize normal postsurgical findings and common postoperative complications.
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ABSTRACT: Oncologic, reconstructive, and cosmetic breast surgery has evolved in the last 20 years. Familiarity with cutting-edge surgical techniques and their imaging characteristics is essential for radiologic interpretation and may help avert false-positive imaging findings. Novel surgical techniques include skin- and nipple-sparing mastectomies, autologous free flaps, autologous fat grafting, and nipple-areola-complex breast reconstruction. These techniques are illustrated and compared with conventional surgical techniques, including modified radical mastectomy and autologous pedicled flaps. The role of magnetic resonance (MR) imaging in surgical planning, evaluation for complications, and postsurgical cancer detection is described. Breast reconstruction and augmentation using silicone gel-filled implants is discussed in light of the Food and Drug Administration's recommendation for MR imaging screening for "silent" implant rupture 3 years after implantation and every 2 years thereafter. Recent developments in skin incision techniques for reduction mammoplasty are presented. The effects of postsurgical changes on the detection of breast cancer are discussed by type of surgery. ©RSNA, 2014.Radiographics 05/2014; 34(3):642-60. DOI:10.1148/rg.343135059 · 2.73 Impact Factor