Breast SurgeryThe Superiorly Based Partial Rectus Abdominis and External Oblique Flap for Lower Pole Coverage in Prosthetic Breast Reconstruction A Prospective Cohort Study of 47 Consecutive FlapsLam, Quoc (Tai Khoa) MBBS, MS, FRACSa; Nowicki, Jake MDa; Crittenden, Tamara BAppSc (Hons)a,b; Howes, Benjamin H.L. MBBSb; Dean, Nicola R. MBChB, FRACSa,bAuthor Information From the aDepartment of Plastic and Reconstructive Surgery, Flinders Medical Centre, Adelaide, South Australia, Australia bCollege of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia. Received September 2, 2019, and accepted for publication, after revision December 28, 2019. Conflicts of interest and sources of funding: none declared. Presented at: Royal Australian College of Surgeons Annual Scientific Congress 2018, Sydney. Reprints: Jake Nowicki, MD, Department of Plastic Surgery, Level 5, Flinders Medical Centre Flinders Drive, Bedford Park, Adelaide, South Australia, 5042, Australia. E-mail: [email protected]. Annals of Plastic Surgery: November 2020 - Volume 85 - Issue 5 - p 481-487 doi: 10.1097/SAP.0000000000002296 Buy Metrics Abstract Background This study evaluated health related quality of life and morbidity in patients who had a superiorly based partial rectus abdominis and external oblique (SPREO) flap for lower pole coverage as a component of 2-stage prosthetic breast reconstruction. Methods A prospective cohort study of patients undergoing immediate and delayed 2-stage breast reconstruction including a SPREO flap for lower pole coverage was conducted. The BREAST-Q and a study-specific questionnaire were used to determine outcomes after this procedure. BREAST-Q questionnaires were completed preoperatively and postoperatively and compared with normative values. Results BREAST-Q questionnaires were completed by 27 women. The mean patient age was 54.3 ± 9.6 years. Mean BREAST-Q scores improved significantly between preoperative and postoperative time points in Satisfaction with Breasts (preoperative 43.2 ± 26.9, postoperative 66.2 ± 19.5, P = 0.001) and Psychosocial Wellbeing (preoperative 59.4 ± 16.4 postoperative 75.5 ± 19.4, P = 0.002). Mean scores were not significantly different in the domains Physical Wellbeing Chest, Physical Wellbeing Abdomen and Sexual Wellbeing. Postoperative BREAST-Q scores were significantly higher (P < 0.05) than previously published normative scores in Satisfaction with Breasts. Conclusions This study reports the use of the SPREO flap for lower pole coverage in 2-stage prosthetic breast reconstruction and demonstrates that it may be a useful addition to the existing repertoire of flaps used in breast reconstruction. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.