"Reverse Bay of Bengal" Modification of Grisotti Flap for Reconstruction of Central Quadrant Tumors

Central quadrant breast cancers pose a significant oncoplastic challenge. While conventional mastectomy and the Grisotti flap technique remain options, alternative approaches such as reverse batwing and perforator-based flaps offer additional possibilities for breast conservation. The Grisotti flap, despite its utility, has limitations, particularly in non-ptotic breasts, where it may lead to lateral fullness and suboptimal cosmesis. In this report, we describe the "Reverse Bay of Bengal" modification of the Grisotti flap, designed to address these limitations by preserving chest wall perforators and avoiding excessive lateral bulging. This technique offers an alternative for patients with centrally located tumors requiring nipple-areola complex (NAC) excision.