Making the most of computed tomography imaging in preoperative assessment and planning of abdomen-based flap breast reconstruction

Computed tomography angiography (CTA) offers substantial benefits for reconstructive surgeons in preoperative planning for abdomen-based flap procedures in breast reconstruction. The abdominal perforator-based autologous breast reconstruction has become the gold standard due to its superior cosmetic outcomes and high patient satisfaction. Meticulous preoperative planning is crucial for the success of deep inferior epigastric artery perforator (DIEP) flap breast reconstruction. In this context, CTA, recognized as the gold standard for perforator mapping, provides crucial insights into patient anatomy, optimizing flap design and elevation. This study aims to go beyond the role of CTA for perforator mapping and summarize the wealth of information that can be obtained from preoperative imaging tools for abdomen-based flaps in breast reconstruction. Such information not only aids in assessing the risk of postoperative complications but also supports the design of various flaps beyond DIEP. Furthermore, we will introduce the latest methods for utilizing this information to assist during preoperative planning and intraoperative decision making.