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Anterolateral thigh flap for postmastectomy breast reconstruction
Fu-chan Wei1, Sinikka Suominen, Ming-huei Cheng
1Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, 199 Tung Hwa North Road, Taipei, Taiwan. fcw2007@adm.cgmh.org.tw
Plastic and Reconstructive Surgery
|June 28, 2002
Summary
The anterolateral thigh flap is a viable alternative for breast reconstruction when lower abdominal flaps are not suitable. This method offers superior tissue quality and allows for a two-team surgical approach, improving outcomes.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Oncology
Background:
- Lower abdominal flaps are standard for postmastectomy breast reconstruction.
- Contraindications include inadequate tissue, prior surgery, or future pregnancy plans.
- Gluteal flaps are a second option but have limitations in tissue quality and surgical approach.
Observation:
- The anterolateral thigh flap was used in five breast reconstructions (two secondary, three immediate).
- Flap characteristics: mean specimen weight 350g, mean flap weight 410g, skin islands 4x8cm to 7x22cm, fat pad 10x12cm to 14x22cm, pedicle length 7-15cm.
- All flaps were successful, with one case of minor fat necrosis.
Findings:
- Anterolateral thigh flaps offer superior tissue quality and pliability compared to gluteal flaps, comparable to abdominal flaps.
- This technique allows for a two-team approach with the patient in a supine position, simplifying surgery.
- Adequate soft tissue volume can be achieved, even in thin patients.
Implications:
- The anterolateral thigh flap serves as a valuable alternative for breast reconstruction when abdominal flaps are contraindicated.
- It provides a reconstructive option with good aesthetic and functional outcomes.
- Patient counseling regarding scar placement is important.