Reply: Comparative Analysis of Single versus Stacked Free Flap Breast Reconstruction: A Single-Center Experience
Min‐Jeong Cho, Nicholas T. Haddock, Sumeet S. Teotia
Abstract
Sir: We thank Drs. Stocco, Ramella, Papa, and Arnež for their interest in and comments on our article, “Comparative Analysis of Single versus Stacked Free Flap Breast Reconstruction: A Single-Center Experience.”1 The goal of our article was to establish the safety and reliability of stacked flaps in a busy breast microsurgery practice and assess our complications. In their letter regarding our study, Stocco et al. discuss the importance of patient-reported outcomes in breast reconstruction and the possibility of including a patient-reported outcome as a part of our study. We agree with the authors that patient-reported outcomes such as the BREAST-Q are crucial for measuring the effect of autologous breast reconstruction.2–4 Recently, the American Society of Plastic Surgeons commissioned the Autologous Breast Reconstruction Performance Measures Work Group to develop quality measures for patients who are undergoing autologous breast reconstruction.5 These measures include coordination of care, BREAST-Q scores, length of stay, operative time, and rate of blood transfusion.5 As the complexity and options for autologous breast reconstruction increase, the need for standardizing patient outcomes is rising. The inclusion of BREAST-Q scores as one of the outcome measures shows its importance. Currently, we have performed over 500 stacked free flap breast reconstructions at our center since the publication of the original article. In addition, we have expanded our options for stacked free flaps by adding stacked lumbar artery perforator flaps and four flaps (deep inferior epigastric perforator and lumbar artery perforator flaps) from bipedicled deep inferior epigastric perforator flaps, stacked profunda artery perforator flaps, and four flaps (deep inferior epigastric perforator and profunda artery perforator flaps).6–8 Furthermore, we have started to include the BREAST-Q as a part of our outcome assessment. As the authors have recommended, we hope to share our results in the future. DISCLOSURE The authors have no financial interest to declare in relation to the content of this communication.