Oncoplastic volume replacement technique for the upper inner quadrant using the omental flap

Area of Science:

• Oncoplastic surgery
• Reconstructive surgery
• Surgical oncology

Background:

• Large defects in the upper inner quadrant (UIQ) of the breast after oncologic resection can lead to nipple displacement.
• Traditional breast-conserving surgery (BCS) techniques may struggle to adequately address UIQ defects.

Purpose of the Study:

• To evaluate the efficacy of using a laparoscopically harvested omental flap (OF) for partial breast reconstruction in the UIQ.
• To present surgical experiences and outcomes of this oncoplastic volume replacement technique.

Main Methods:

• Wide breast tissue excision (>20%) was performed, primarily via a periareolar incision.
• A pedicled omental flap was harvested laparoscopically and tunneled to the UIQ defect.
• The omental flap was used to reconstruct the defect in the upper inner quadrant.

Main Results:

• Thirty patients underwent UIQ reconstruction with OF.
• Median resected breast volume was 142g; one patient had positive margins (3.3%).
• Excellent or good cosmetic outcomes were reported by over 80% of patients, with one donor-site ventral hernia.

Conclusions:

• The omental flap is a viable and effective technique for reconstructing large UIQ defects in BCS.
• This method provides satisfactory aesthetic results and addresses a challenging area for other reconstructive methods.