L-positioned Perforator Propeller Flap for Partial Breast Reconstruction with Axillary Dead Space

Area of Science:

• Plastic Surgery
• Surgical Oncology

Background:

• Partial breast reconstruction is crucial after mastectomy for breast cancer.
• Reconstructing both partial breast defects and axillary dead space after mastectomy and lymph node dissection often requires multiple flaps.
• Harvesting multiple local flaps in adjacent areas can be surgically challenging.

Observation:

• The L-positioned perforator propeller flap (PPF) was utilized in two patients (46 and 47 years old) with upper outer quadrant breast cancer.
• The longer lobe of the L-positioned PPF reconstructed the partial breast defect, while the smaller lobe addressed the axillary dead space.
• Reconstruction times were efficient, averaging 1 hour and 53 minutes per case.

Findings:

• Successful aesthetic breast reconstruction was achieved in both patients using the single L-positioned PPF.
• No postoperative complications were observed.
• Patients tolerated subsequent radiotherapy on the reconstructed areas without complications.

Implications:

• The L-positioned PPF offers a single-flap solution for simultaneous breast and axillary defect reconstruction.
• This technique simplifies the surgical procedure, potentially reducing invasiveness and improving aesthetic results.
• It provides a safe and effective option for patients undergoing partial mastectomy with axillary lymph node dissection.