Reliability of Chest Wall Perforator Flaps for Breast Reshaping Following Massive Weight Loss

Conditions for inclusion in the study:

• Ptotic and deflated breasts following massive weight loss (MWL) with Pittsburgh Rating Scale (PRS) score of 2-3 as described by Songet al. (Song AY, Jean RD, Hurwitz D, Fernstrom MH, Scott JA, Rubin JP. A Classification of Contour Deformities after Bariatric Weight Loss: The Pittsburgh Rating Scale. Plast Reconstr Surg. 2005;116:1535-1544).
• MWL is defined as loss of 50% or greater of excess weight, following surgical or non-surgical interventions.
• Stable weight for at least 6 months, to achieve metabolic and nutritional homeostasis and decrease the risk of surgical complications.
• Body mass index (BMI): 18.5 - 30 kg/m2.
• Patients seeking autologous augmentation or refusing implants.
• Patients requiring simultaneous contouring of lateral chest wall redundancy.

Exclusion Criteria:

• Weight fluctuations in the previous 6 months.
• Medical co-morbidities (e.g., uncontrolled diabetes, uncontrolled hypertension, thyroid diseases, hormonal disturbances, cardiopulmonary diseases).
• Hereditary conditions that affect wound healing (e.g., Ehler Danlos Syndrome, Progeria).
• Active smokers (Smokers are required to stop smoking 1 month before surgery).
• Nutritional deficiencies (e.g., iron, vitamin B12, protein, folate).
• Previous breast surgery.
• Congenital breast deformity (e.g., tuberous breasts).
• Breast masses.
• Pregnant or lactating patients.

Local breast examination: