Between 2009 and 2011, the total amount of autologous breast reconstruction discharges was relatively stable, but the number of DIEP flaps increased significantly. Review of the Healthcare Cost and Utilization Project Nationwide Inpatient Sample data shows that, compared with LD, pTRAM, and fTRAM flaps, the DIEP flap is associated with higher charges and costs.
PurPose: Incremental tissue expansion is commonly used for mastectomy patients in the delayed breast reconstruction process. After mastectomy, an inflatable tissue expander is placed in the subpectoral pocket and filled with saline periodically; fixed volumes, determined qualitatively by the surgeon, are added over the course of weeks until an adequate pocket is available to accommodate a permanent implant. This method relies on the physician's subjective opinions of aesthetic targets and 2D measurements. 3D photographic technology has the potential to quantitatively improve the process by measuring patients' natural breast volume thereby setting a target for fill volumes during reconstruction.
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