الفهرس 
Predictive pre-operative estimation of abdominal flap volume in breast reconstruction cases
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Abstract
Background: Breast reconstruction entered the modern era with the introduction of the abdominal flap in 1982 by Hartrampf, Scheflan, and Black. This procedure now constitutes 10-15% of breast reconstructions performed in the United States (ASPS statistics, 2016) and the abdominal flap has proven to be the autogenous tissue of choice for breast reconstruction. Patient{u2019}s selection for breast reconstruction using abdominal flap needs to be determined pre-operatively for the feasibility of surgery, especially in lean patients. To obtain pleasing symmetry when using abdominal flap for breast reconstruction, an optimal amount of abdominal tissue is required and should be estimated prior to surgery. Methods: Patients with unilateral modified radical mastectomies (MRM) requesting delayed breast reconstruction had their abdominal flap volume (AFV) measured (pre-operatively)using a measuring tape and Ultra-sound (for obtaining the flap thickness). Contra-lateral breast volume (BV)is measured using MRI. The latter value is compared to the abdominal flap volume. Additionally, BMI is measured for every patient. A correlation between the patient{u2019}s BMI, Breast Volume (BV) and Abdominal flap volume (AFV) is obtained. Results: Twenty-patients (20) with mean age 39 years (range 26-49, SD 6) and mean BMI 29 (range 23-35, SD 4) were involved in this study. The mean breast volume is 620 cc and mean abdominal flap volume is 770 cc (excluding zone IV). The mean breast to abdominal flap volume (without zone IV)is 0.8. Conclusion: Abdominal flap for breast reconstruction remains one of the reliablemethods for breast reconstruction especially in the developing countries where the access to expensive/sophisticated tools may be limited. Our pre-operative measurements of the breast, abdominal flap volume, and BMI enabled us to establish a relationship between those variables, identify the feasibility of surgery, the need for additional volume enhancements and breast symmetrization procedures in patients seeking breast reconstruction