Objective: Various surgeons adopt various vulvar reconstruction methods for different types of vulvar defects to restore anatomical structures. Vulvar reconstruction has relatively few references as it is performed in many different ways. Our report aimed to create a simplified reconstruction algorithm that can be used to select the reconstruction flap and to compare clinical outcomes.

Methods: The patients who underwent vulvar reconstruction between April 2017 and May 2020 were retrospectively reviewed. The reconstruction flap was selected according to a suggested algorithm, which accounted for the defect location depending on the vulvo-thigh junctional crease-the visual landmark of the inferior pubic ramus-and proper perforator location. Postoperative surgical complications, functional outcomes, and oncologic outcomes were analyzed according to the histologic and flap types.

Results: Forty-seven patients underwent reconstruction with 31 internal pudendal artery perforator flaps (66%) and 16 profunda artery perforator flaps or transverse upper gracilis flaps (34%). The histologic type included 21 extramammary Paget disease (44.7%), 20 squamous cell carcinoma (42.6%), and 6 other types (12.8%). Postoperative complications, including wound and functional complications, occurred in 10 patients (21.3%). There were more cases of wound complications with profunda artery perforator flaps and transverse upper gracilis flaps (37.5%) than those with internal pudendal artery perforator flaps (12.9%) (P = 0.04). There were 7 cases (14.9%) of 2-year oncologic recurrence with no significant differences in terms of histologic or flap types.

Conclusions: According to our suggested simplified algorithm, various types of flaps resulted in reliable surgical outcomes with minimal complication rates and acceptable functional and oncologic outcomes, and the primary goals of vulvar reconstruction were achieved effectively. Using our algorithm, selection of the reconstruction method could be simplified and specified despite the complexity of vulvar defects.

Background: Brassiere cup size is defined as the difference in chest circumference between the inframammary fold and the fullest part of the breast. However, a large number of women are not aware of the correct definition and are prone to wearing incorrectly-sized brassieres. In this report, the authors compared the cup size of worn brassieres and the actual measurement.

Methods: This study was a retrospective review of patients who had undergone breast reconstruction operation between May 2020 and June 2021. All patients who visited the plastic surgery clinic for breast reconstruction were inquired about their cup size, and their breast circumferences were measured. The patient demographic information, ptosis grade, mastectomy specimen weight, measured breast circumference, and known cup size were analyzed.

Results: Overall, 163 women were included. Notably, 92 of 163 patients (56.4%) were wearing a correctly-sized brassiere. Patients were more likely to wear a correctly-sized brassiere as the cup size became smaller. Moreover, patients with A-cup breasts tended to wear larger brassieres, whereas patients with B and C-cup breasts tended to wear smaller brassieres than their actual breast cup size.

Conclusions: Approximately one in two women do not know their correct brassiere cup size. Women tend to wear a brassiere of the wrong size as their cup size becomes larger. Therefore, it is important for surgeons to be aware of their patient's brassiere wearing habit and their perception when a surgery, such as augmentation or reconstruction, is planned.