Autologous breast reconstruction with the inchworm flap in an obese woman

Breast cancer may particularly occur in the obese female population. Although mastectomy can be a life-saving procedure, it frequently leaves soft tissue defects and deformities that can be psychologically and esthetically upsetting to the patient. A number of reconstructive methods have been utilized including prosthetic implants, TRAM flaps, and latissimus dorsi myocutaneous flaps. We present an obese woman who underwent a novel method of post-mastectomy breast reconstruction using a staged lateral chest wall fasciocutaneous advancement flap which we term the 'inchworm flap'. The patient had good outcome with no complications. In a select group of obese patients who have redundant lateral chest wall soft tissue following mastectomy, this technique can be a successful means of recreating the breast mound using autologous tissue.