Optimizing Delayed Breast Reconstruction: A Case Study on DIEP Flap with Advanced Imaging Techniques

A 43-year-old female patient with a history of left breast invasive carcinoma, treated with mastectomy and adjuvant therapy, presented for delayed breast reconstruction after nearly three years of stable disease. Following the mastectomy, the patient experienced significant psychological distress due to the absence of her left breast, severely impacting her quality of life. Routine follow-up examinations revealed no recurrence or metastasis. Preoperative assessments, including CT scans, 3D reconstruction, and computed tomography angiography (CTA), were performed to accurately estimate the contralateral breast volume and evaluate abdominal perforator vessels for the DIEP (Deep Inferior Epigastric Perforator) flap. On March 27, 2024, the patient underwent delayed one-stage bipedicle DIEP flap breast reconstruction. Preoperative imaging guided the surgical approach, ensuring precise flap design, vascular pedicle selection, and recipient site preparation. The surgery was completed successfully with minimal complications, and the reconstructed breast achieved excellent symmetry and functionality. Postoperatively, the patient had linear scars at both donor and recipient sites, with no donor site complications, and preserved abdominal wall and shoulder joint function. No flap necrosis or vascular compromise was observed, and the patient reported high satisfaction with the aesthetic results. She is currently receiving endocrine therapy, with no signs of tumor recurrence or metastasis at follow-up. This case highlights the role of DIEP flap breast reconstruction in improving patient outcomes and quality of life, emphasizing the importance of advanced imaging techniques in preoperative planning and surgical success. DIEP flap offers significant advantages in autologous breast reconstruction, providing natural, durable results with minimal complications, making it a preferred option for patients requiring delayed reconstruction.