To investigate the application value of donor-site perfusion via turbocharging in immediate deep inferior epigastric perforator (DIEP) flap breast reconstruction following breast cancer surgery.

A retrospective analysis was conducted on the clinical data of 12 female patients with breast cancer who underwent nipple-sparing mastectomy followed by immediate DIEP flap breast reconstruction perfused by turbocharging (turbocharged DIEP) in the Shenzhen Hospital of Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between January 2024 and December 2025. There were 3 cases of stage Ⅰ, 8 cases of stage Ⅱ and 1 case of stage Ⅲ. Preoperative computed tomography angiography (CTA) was performed in all patients to accurately locate the number and anatomical positions of DIEP. The number of donor perforator vessels, the diameters of arteries and veins, and the number of vessels used for turbocharging anastomosis were systematically recorded during surgery. Postoperative follow-up was conducted to assess flap survival rate and the incidence of complications, and the BREAST-Q Questionnaire was used to quantitatively evaluate patient satisfaction with reconstructed breast appearance and functional recovery of the donor and recipient sites.

Double-pedicle DIEP flap transplantation was successfully performed in all 12 patients. The flap harvest area ranged from 12.0 cm×24.0 cm to 14.0 cm×30.0 cm, with an average weight of (759.17±99.91) g and operative time of (487.67±97.21) min. Intraoperative anatomical dissection identified 3 perforator vessels in 8 cases and 4 perforator vessels in 4 cases; among them, single-artery turbocharging was used in 8 cases and double-artery turbocharging in 4 cases. The diameter of turbocharged arteries was (0.75±0.19) mm, and the venous diameter was (0.94±0.12) mm. All patients were followed up for 3.0-14.5 months with a median follow-up of 6.3 months. All transplanted flaps survived completely, with no perioperative complications such as flap necrosis, hematoma or infection. The mean BREAST-Q score was (91.83±2.52), indicating high patient satisfaction with the appearance of reconstructed breasts and the functional recovery of donor and recipient sites. No local recurrence or distant metastasis occurred during the follow-up period.

Under strict patient selection, turbocharged-DIEP breast reconstruction has good safety, feasibility and aesthetic effects, which can be used for immediate breast reconstruction after breast cancer surgery.