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"Locoregional perforator flaps in breast reconstruction: An anatomic review & quadrant algorithm"
Christian Chartier1, Tyler Safran2, Becher Alhalabi2
1McGill University, Faculty of Medicine, "Division of Plastic and Reconstructive Surgery, Jewish General Hospital, Montreal, Canada.
Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
|February 19, 2022
Summary
Locoregional perforator flaps are increasingly used in breast reconstruction, offering benefits like improved donor-site function. While complications occur, this review analyzes flap types and outcomes for better patient results.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Oncology
Background:
- Plastic surgeons utilize perforator anatomy for breast reconstruction, focusing on esthetic outcomes, patient satisfaction, and donor-site function.
- The widespread adoption of locoregional perforator flaps in post-mastectomy and post-breast-conserving surgery (BCS) reconstruction is noted.
Purpose of the Study:
- To review the literature on locoregional perforator flaps in post-mastectomy breast reconstruction.
- To analyze flap categories, advantages, disadvantages, and complications associated with these techniques.
Main Methods:
- A PubMed literature search identified studies on locoregional perforator flaps for breast reconstruction.
- Selected articles were analyzed, grouped by flap type, and assessed for reported outcomes and complications.
Main Results:
- 30 of 101 articles were retained, detailing the use of TDAP, LICAP, AICAP, LTAP, or IMAP flaps in 829 patients.
- Complications were reported in 17.5% of patients, with fat necrosis/steatofibrosis (31 cases) and flap congestion (11 cases) being most common.
Conclusions:
- Locoregional flap-based reconstruction may offer advantages in post-BCS settings.
- Benefits include sparing donor-site musculature and nerve supply, potentially minimizing adverse events.
