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• W4234204503 abstract "Sir: We appreciate the authors’ interest in our recent article entitled “Deconstructing the Reconstruction: Evaluation of Process and Efficiency in Deep Inferior Epigastric Perforator Flaps.”1 We appreciate the review and careful analysis by Dr. Daar et al. of our work focused on process analysis in breast reconstruction with deep inferior epigastric perforator (DIEP) flaps. The authors bring forth very valid points for discussion that are certainly at the center of our patient-centric approach to breast reconstruction.2 Our primary goal is also focused on achieving aesthetic breast reconstruction, and we in fact feel that efficiency and standardization of the first eight steps, highlighted in this article, has allowed more focus on management of the flap at the breast recipient site. As the authors highlight, this includes pedicle management, flap inset, and flap tailoring. We would also add that management of the donor site has gained increased focus in our practice with increased efficiency. The lack of inclusion of these very critical steps within this study is not secondary to a lack of importance, but instead an effort to simplify the discussion on the less artistic and more technical aspects of the DIEP flap procedure. We firmly believe that efficiency in the first eight steps complements the final goal of aesthetic breast reconstruction, and we never compromise our final result for efficiency. We highlight this with a presented procedure of a 40-year-old woman that underwent bilateral DIEP flaps in 4 hours 22 minutes (Fig. 1). This is a typical intermediate result showing a reasonable early outcome without signs of loss of focus during the aesthetic inset portions. She has since completed breast reconstruction with one additional operation for nipple reconstruction.Fig. 1.: A 40-year-old woman that underwent bilateral DIEP flap surgery in 4 hours 22 minutes (3-month follow-up before completion of breast reconstruction).We appreciate the authors’ suggestion to extend our analysis throughout the entire procedure. We agree and continue to evaluate our surgical technique, process, and outcomes. This process mapping is ultimately important for the entire procedure. DISCLOSURE The authors have no financial interest to declare in relation to the content of this communication. No funding was received for this communication. Nicholas T. Haddock, M.D.Sumeet S. Teotia, M.D.Department of Plastic SurgeryUniversity of Texas Southwestern Medical CenterDallas, Texas" @default.
• W4234204503 created "2022-05-12" @default.
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• W4234204503 date "2020-12-18" @default.
• W4234204503 modified "2023-09-23" @default.
• W4234204503 title "Reply: Deconstructing the Reconstruction: Evaluation of Process and Efficiency in Deep Inferior Epigastric Perforator Flaps" @default.
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• W4234204503 doi "https://doi.org/10.1097/prs.0000000000007651" @default.
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