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In deep inferior epigastric perforator (DIEP) flap breast reconstruction, preoperative planning using computed tomography angiography (CTA) has become the gold standard and allows for precise mapping of the abdominal wall vasculature. The use of 3D modeling in breast reconstruction provides the surgeon with the ability to see the perforators and their associated diameters, intramuscular courses, and arborization. These 3D models can be cross-referenced with intraoperative findings to allow for the most informed decision regarding perforator use, limit unnecessary dissection, and has been shown to reduce flap harvest time compared to CT angiography alone (Ogunleye AA et al. Arch Plast Surg 47(5):428–434. https://doi.org/10.5999/aps.2020.00829 , 2020). Furthermore, 3D printed 2D templates can be placed over the anterior abdominal wall to trace an outline of the proposed flap skin marking and can be utilized as an invaluable teaching tool. In this chapter, we present our use of 3D modeling to create 2D templates and aim to elucidate the processes, requirements, benefits, and potential pitfalls of this virtual surgical planning process for complex microsurgical breast reconstruction.

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Two and Three-Dimensional Modeling in Breast Reconstruction

  • 章节

  • 发表日期：

    2025年

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  • Fuad Abbas,
  • Rommy Obeid,
  • Riley Marlar,
  • Yazen Alfayez,
  • Ryan Klatte,
  • Risal Djohan,
  • Sarah N. Bishop

摘要

In deep inferior epigastric perforator (DIEP) flap breast reconstruction, preoperative planning using computed tomography angiography (CTA) has become the gold standard and allows for precise mapping of the abdominal wall vasculature. The use of 3D modeling in breast reconstruction provides the surgeon with the ability to see the perforators and their associated diameters, intramuscular courses, and arborization. These 3D models can be cross-referenced with intraoperative findings to allow for the most informed decision regarding perforator use, limit unnecessary dissection, and has been shown to reduce flap harvest time compared to CT angiography alone (Ogunleye AA et al. Arch Plast Surg 47(5):428–434. https://doi.org/10.5999/aps.2020.00829 , 2020). Furthermore, 3D printed 2D templates can be placed over the anterior abdominal wall to trace an outline of the proposed flap skin marking and can be utilized as an invaluable teaching tool. In this chapter, we present our use of 3D modeling to create 2D templates and aim to elucidate the processes, requirements, benefits, and potential pitfalls of this virtual surgical planning process for complex microsurgical breast reconstruction.