Total breast reconstruction using thoracodorsal artery perforator (TDAP) flap with or without implants

Abstract

Introduction: The thoracodorsal artery perforator (TDAP) flap has been increasingly used for breast reconstruction mainly due to reduced donor site morbidity compared to latissimus dorse (LD) flap. TDAP flap was mainly described for partial reconstruction of breast defects following breast conserving surgery. This study describes the use of the TDAP flap in total breast reconstruction with or without synthetic implants in two breast units. Methods: Between June 2017 and June of 2022, seven patients were included. Six patients from the Oncology Center, Egypt and one patient from Cambridge Breast Unit. Preoperative perforator mapping method was recorded. Patients’ demographic data, type of mastectomy and reconstruction and surgical outcome were recorded. Results: Five patients had total breast reconstruction without implants, whilst two patients had implant-enhanced TDAP reconstruction. The mean age of was 39 years (31-43), and the mean mean body mass index (BMI) was 28 kg/m2 (23-36). Median hospital stay was 3 days. All patients had immediate breast reconstruction following mastectomy without the need for contralateral symmetrization or corrective surgery. No seroma was reported. Only one patient had complete flap loss, while one patient who had minor wound infection.