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Related Experiment Video

Updated: Jun 5, 2025

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
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Technical and Analytical Approach for Breast Reconstruction With IMAP Propeller Flap.

Antonio Spaggiari1, Wayne A Morrison2, Caterina Marra1

  • 1From the Plastic and Reconstructive Surgery Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.

Plastic and Reconstructive Surgery. Global Open
|December 6, 2024
PubMed
Summary

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This summary is machine-generated.

This study revisits the breast-sharing technique for breast reconstruction after mastectomy. Combining computed tomography angiography (angio-CT) and indocyanine green (ICG) imaging improves vascular predictability, making the internal mammary artery perforator (IMAP) flap a viable option for select patients.

Area of Science:

  • Plastic Surgery
  • Surgical Oncology
  • Medical Imaging

Background:

  • The breast-sharing technique utilizes lower quadrants from contralateral reduction mammoplasty for post-mastectomy breast reconstruction.
  • This technique has historically faced challenges with vascular predictability.

Purpose of the Study:

  • To re-evaluate the breast-sharing technique for breast reconstruction.
  • To enhance vascular predictability using preoperative computed tomography angiography (angio-CT) and intraoperative indocyanine green (ICG) imaging.

Main Methods:

  • Twenty-six patients underwent preoperative angio-CT to identify internal mammary artery perforators (IMAP).
  • A Wise skin-pattern reduction facilitated elevation of a flap based on the IMAP.
  • Intraoperative ICG confirmed flap perfusion.

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Main Results:

  • Sixteen breast-sharing flaps were successfully performed after excluding 8 patients.
  • Two cases experienced distal flap venous compromise, and one had an infection.
  • No donor site healing issues were noted; 2 patients required areola repositioning.

Conclusions:

  • The study revitalizes the breast-sharing flap by addressing weaknesses through advanced imaging.
  • The IMAP propeller flap, enhanced by angio-CT and ICG, offers a simpler, safer alternative to free flaps for suitable candidates.