Radiographic Evidence of Neo-vascularization of the Lower Abdominal Soft Tissues in Patients After Abdominoplasty and Previous Abdominal Free Flap Breast Reconstruction

A series of figures illustrating the vascular anatomy apparent from imaging of patients after abdominally-based free flap and abdominal resections (abdominoplasty). Created for Dr. David Song, Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital. Published online in European Journal of Plastic Surgery June 2023 https://doi.org/10.1007/s00238-023-02076-y

Reperfusion of the abdominal wall by type of abdominal flap resection. A figure of the patterns of reperfusion by the type of flap resection. This figure depicts the results of the subanalysis of individuals with both pre and postoperative imaging. By using patients as their own controls, we could assess if there was a change in the number of prominent vessels over time, and if this differed by surgical procedure performed. A The number of prominent superior vessels was higher following Ab-R (mean number of vessels 2.0) than following Ab-FF (mean number of vessels = 0.4; P = 0.001). This gave a difference in means of − 1.6 ± 0.4 and 95% confidence interval of “− 2.4 to − 0.8”. B The illustration of superior dominance is provided for reference and C demonstrates the change in number of prominent superior vessels over time in each group. The lines between points represent the trajectories of individual patients and the number of prominent superior vessels they had on preoperative and postoperative imaging. D There was no significant differences between the mean number of recanalized inferior vessels (mean number of vessels Ab-R 0 vs. Ab-FF 0.5, P = 0.206). However, none of the patients who underwent Ab-R revealed prominent inferior vessels postoperatively. E–F This is visible in F and suggests that the vascular pattern after Ab-FF may more closely approximate the preoperative vasculature than Ab-R

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