Oncoplastic Volume Replacement Using Local Perforator Flaps
Association of Breast Surgery ePoster Library. Highton L. 05/15/17; 166215; P119
Ms. Lyndsey Highton
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Abstract
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Introduction
Patients undergoing breast-conserving surgery require closure of the excisional defect to ensure a good aesthetic outcome. Volume replacement may not be possible by local mobilisation or mammoplasty in small non-ptotic breasts. This can be addressed by importing tissue and we describe our unit experience using local perforator flaps.
Methods
We report a consecutive series of lateral chest wall and thoracodoral artery perforator flaps for partial breast reconstruction.
Results
Since January 2014, 40 patients have had reconstruction with local perforator flaps, at a mean age of 52 years (26-75 years). This includes 34 cases of immediate reconstruction following tumour excision and 6 revisional cases to correct existing defects. The flaps used were based on the LICAP (18), LICAP & LTAP (18), LTA (2) and TDAP (2) vessels. A two-stage approach was used for almost all primary cancer cases (33). Mean WLE weight was 66g (24-137g). Pathology included IDC (26), ILC (3) and DCIS (5) and radial margins were involved following initial excision in 26%, requiring margin excision at the second stage. The cosmetic outcomes have been good with a low rate of complications, including an infected seroma (1) and delayed wound healing (1). There have been no issues with surveillance mammograms post-operatively.
Conclusion
The use of local perforator flaps is a reliable technique to avoid and correct breast defects, with minimal donor morbidity. These techniques allow a good aesthetic outcomes to be achieved, extending breast-conserving surgery to patients with a high tumour to breast size ratio.
Patients undergoing breast-conserving surgery require closure of the excisional defect to ensure a good aesthetic outcome. Volume replacement may not be possible by local mobilisation or mammoplasty in small non-ptotic breasts. This can be addressed by importing tissue and we describe our unit experience using local perforator flaps.
Methods
We report a consecutive series of lateral chest wall and thoracodoral artery perforator flaps for partial breast reconstruction.
Results
Since January 2014, 40 patients have had reconstruction with local perforator flaps, at a mean age of 52 years (26-75 years). This includes 34 cases of immediate reconstruction following tumour excision and 6 revisional cases to correct existing defects. The flaps used were based on the LICAP (18), LICAP & LTAP (18), LTA (2) and TDAP (2) vessels. A two-stage approach was used for almost all primary cancer cases (33). Mean WLE weight was 66g (24-137g). Pathology included IDC (26), ILC (3) and DCIS (5) and radial margins were involved following initial excision in 26%, requiring margin excision at the second stage. The cosmetic outcomes have been good with a low rate of complications, including an infected seroma (1) and delayed wound healing (1). There have been no issues with surveillance mammograms post-operatively.
Conclusion
The use of local perforator flaps is a reliable technique to avoid and correct breast defects, with minimal donor morbidity. These techniques allow a good aesthetic outcomes to be achieved, extending breast-conserving surgery to patients with a high tumour to breast size ratio.
Introduction
Patients undergoing breast-conserving surgery require closure of the excisional defect to ensure a good aesthetic outcome. Volume replacement may not be possible by local mobilisation or mammoplasty in small non-ptotic breasts. This can be addressed by importing tissue and we describe our unit experience using local perforator flaps.
Methods
We report a consecutive series of lateral chest wall and thoracodoral artery perforator flaps for partial breast reconstruction.
Results
Since January 2014, 40 patients have had reconstruction with local perforator flaps, at a mean age of 52 years (26-75 years). This includes 34 cases of immediate reconstruction following tumour excision and 6 revisional cases to correct existing defects. The flaps used were based on the LICAP (18), LICAP & LTAP (18), LTA (2) and TDAP (2) vessels. A two-stage approach was used for almost all primary cancer cases (33). Mean WLE weight was 66g (24-137g). Pathology included IDC (26), ILC (3) and DCIS (5) and radial margins were involved following initial excision in 26%, requiring margin excision at the second stage. The cosmetic outcomes have been good with a low rate of complications, including an infected seroma (1) and delayed wound healing (1). There have been no issues with surveillance mammograms post-operatively.
Conclusion
The use of local perforator flaps is a reliable technique to avoid and correct breast defects, with minimal donor morbidity. These techniques allow a good aesthetic outcomes to be achieved, extending breast-conserving surgery to patients with a high tumour to breast size ratio.
Patients undergoing breast-conserving surgery require closure of the excisional defect to ensure a good aesthetic outcome. Volume replacement may not be possible by local mobilisation or mammoplasty in small non-ptotic breasts. This can be addressed by importing tissue and we describe our unit experience using local perforator flaps.
Methods
We report a consecutive series of lateral chest wall and thoracodoral artery perforator flaps for partial breast reconstruction.
Results
Since January 2014, 40 patients have had reconstruction with local perforator flaps, at a mean age of 52 years (26-75 years). This includes 34 cases of immediate reconstruction following tumour excision and 6 revisional cases to correct existing defects. The flaps used were based on the LICAP (18), LICAP & LTAP (18), LTA (2) and TDAP (2) vessels. A two-stage approach was used for almost all primary cancer cases (33). Mean WLE weight was 66g (24-137g). Pathology included IDC (26), ILC (3) and DCIS (5) and radial margins were involved following initial excision in 26%, requiring margin excision at the second stage. The cosmetic outcomes have been good with a low rate of complications, including an infected seroma (1) and delayed wound healing (1). There have been no issues with surveillance mammograms post-operatively.
Conclusion
The use of local perforator flaps is a reliable technique to avoid and correct breast defects, with minimal donor morbidity. These techniques allow a good aesthetic outcomes to be achieved, extending breast-conserving surgery to patients with a high tumour to breast size ratio.
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