The Modified Crescenteric Anterior Intercostal Perforator Flap

Area of Science:

• Surgical Oncology
• Plastic and Reconstructive Surgery
• Breast Surgery

Background:

• Lower pole breast cancers pose reconstructive challenges, often leading to deformities with standard wide local excision.
• Oncoplastic surgery techniques, including local flaps, aim to improve cosmetic results alongside oncological safety in breast conservation.
• Anterior intercostal artery perforator (AICAP) flaps are valuable for partial breast reconstruction due to simplicity and reduced morbidity, but traditional harvests offer limited volume.

Purpose of the Study:

• To describe a modified crescenteric anterior intercostal artery perforator (AICAP) flap technique for lower pole breast reconstruction.
• To present a method that increases tissue volume available for reconstruction compared to traditional AICAP flaps.
• To evaluate the suitability of this modified technique for specific breast types and tumor locations.

Main Methods:

• Description of a modified crescenteric harvest technique for anterior intercostal artery perforator (AICAP) flaps.
• The modification involves 3 extensions of tissue to augment the flap's volume.
• Application of the technique for partial breast reconstruction in lower pole defects.

Main Results:

• The modified technique provides a larger volume of tissue for reconstruction than traditional AICAP flaps.
• The procedure is particularly suitable for small- to medium-sized, non-ptotic breasts with lower pole tumors.
• The approach facilitates increased tissue availability for lower pole breast reconstructions.

Conclusions:

• The modified crescenteric AICAP flap technique is an effective modification for enhancing tissue volume in lower pole breast reconstructions.
• This technique offers a valuable option in oncoplastic surgery to improve cosmetic outcomes for breast-conserving surgery.
• It addresses the limitations of traditional AICAP flaps by providing greater reconstructive capacity.