Outcomes of Chest Wall Perforator Flaps for Partial Breast Reconstruction: A Single-Center, Single-Surgeon Experience

Achieving clear margins in breast-conserving surgery (BCS) can result in significant tissue loss, particularly in women with small breast volumes or large tumours. Oncoplastic BCS aims to ensure an oncologically safe resection with superior cosmetic outcomes. Chest wall perforator flaps (CWPFs) offer a muscle-sparing, volume-replacement option in BCS. This study reports a single-centre, single-surgeon experience using CWPFs for partial breast reconstruction.

A retrospective cohort study was conducted, including all women who underwent wide local excision followed by reconstruction with a CWPF between 2023 and 2025. Demographic, tumour, treatment, and outcome variables were collected from electronic records.

Fifty-five patients (median age 52) underwent CWPF reconstruction, most commonly with lateral intercostal artery perforator flaps (n = 48, 87.3%). Two (n = 2, 3.6%) patients had wound breakdown postoperatively, requiring return to theatre for re-suturing. Our margin re-excision rate was 9.1% (n = 5), and 3.6% of patients (n = 2) required completion mastectomy because final histology identified more extensive disease than preoperative imaging had indicated. No partial or complete flap losses were observed. Two patients (n = 2, 3.6%) required secondary lipofilling sessions for aesthetic purposes.

CWPFs are a reliable, safe, and aesthetically favourable option for partial breast reconstruction, particularly in women with small to moderate breast volumes and minimal ptosis. Rates of complications, flap loss, and re-excision were low and comparable to those reported in the existing literature. Further prospective multi-centre studies that include patient-reported outcomes are warranted to assess long-term satisfaction.