Prospective, Double-Blind Evaluation of Umbilical Reconstruction of Techniques Using Conventional and Crowdsourcing Methods
Charlotte L. van Veldhuisen, BSc, Parisa Kamali, MD, Winona W. Wu, BSc, Babette E. Becherer, BSc, Hani H. Sinno, MD, C.M., M. Eng, Azra A. Ashraf, MD, Ahmed M.S. Ibrahim, MD, Adam M. Tobias, MD, Bernard T. Lee, MD, Samuel J. Lin, MD.
Beth Israel Deaconess Medical Center/ Harvard Medical School, Boston, MA, USA, Boston, MA, USA.
Umbilicoplasty is an important component of deep inferior epigastric perforator (DIEP) flap breast reconstruction. This study evaluated the aesthetics of three different umbilical reconstruction techniques in DIEP flap reconstruction.
From January-April 2013, 23 patients underwent DIEP flap breast reconstruction and intra-operatively they were randomized to receive one of three umbilicoplasty types: a diamond (n=7), oval (n=7), or ‘inverted V’ incision (n=9). Plastic surgeons and members of the general public, identified using an online ‘crowdsourcing’ platform, evaluated aesthetic outcomes in a blinded fashion. Reviewers were shown pre- and post-operative photographs of the umbilicus of all 23 patients and a four-point Likert scale enabled them to rate the new umbilicus on the size, scar formation, shape, localization and overall appearance.
Results for six plastic surgeons and 377 members of the public were retrieved (n=383). The general public demonstrated a significant preference for the oval incision in all five parameters (Figure 1a. overall appearance). There was no preference identified among surgeons (Figure 1b. overall appearance).
This study provides evidence that the general population prefers the aesthetics of the oval umbilicoplasty incision, which contrasts with the lack of preference identified within this group of plastic surgeons. Crowdsourcing has proven an effective tool in surveying the general population, which will enhance the research of post-operative aesthetics in plastic surgery.
Back to 2017 Program