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Lateral Intercostal Artery Perforator (LICAP) Flap for Level II Oncoplastic Breast Reconstruction: Our Initial
Gianluca Marcaccini1,2, Claudia Biagini1,2, Benedetta Daicampi1
1Operative Unit of Oncological and Reconstructive Surgery of the Breast, Livorno Hospital, 57100 Livorno, Italy.
Journal of Personalized Medicine
|October 28, 2025
Summary
Lateral intercostal artery perforator (LICAP) flap reconstruction offers a safe and effective oncoplastic solution for breast-conserving surgery (BCS). This technique provides excellent early cosmetic and patient-reported outcomes with minimal complications.
Area of Science:
- Oncology
- Plastic Surgery
- Breast Surgery
Background:
- Breast-conserving surgery (BCS) with radiotherapy offers comparable oncologic outcomes to mastectomy but can compromise aesthetics in extensive resections.
- Level II oncoplastic techniques, including volume replacement flaps, aim to improve cosmetic results.
- The lateral intercostal artery perforator (LICAP) flap is a muscle-sparing option for lateral breast defects.
Purpose of the Study:
- To evaluate the initial experience and outcomes of using LICAP flaps in Level II oncoplastic breast reconstruction.
- To assess flap-related complications, operative parameters, and aesthetic results following LICAP reconstruction.
Main Methods:
- Retrospective review of patients undergoing BCS with LICAP reconstruction (March 2024 - March 2025).
- Primary outcome: flap-related complications within 90 days.
- Secondary outcomes: operative time, hospital stay, donor-site morbidity, and six-month aesthetic outcomes (Harvard scale, BREAST-Q®).
Main Results:
- Nine patients underwent LICAP reconstruction for tumors ≤pT2 with negative margins.
- Mean operative time: 128 minutes; median hospital stay: 2 days.
- One minor complication (seroma, 11%) managed conservatively; all patients achieved good/excellent Harvard scores; mean BREAST-Q® satisfaction: 79 ± 12.
Conclusions:
- LICAP reconstruction is a safe, efficient, and reliable oncoplastic technique for breast cancer surgery.
- The procedure demonstrates low complication rates, high patient satisfaction, and minimal donor-site morbidity.
- Further prospective studies are warranted to confirm long-term results and refine indications for LICAP flaps.
