Original ArticleMastopexy With Autologous Augmentation After Massive Weight Loss The Intercostal Artery Perforator (ICAP) FlapKwei, Stephanie MD; Borud, Loren J. MD; Lee, Bernard T. MDAuthor Information From the Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Boston, MA. Received December 28, 2005, and accepted for publication March 13, 2006. No financial support. Reprints: Bernard T. Lee, MD, Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, 110 Francis Street, LMOB 5A, Boston, MA 02215. E-mail: [email protected]. Annals of Plastic Surgery: October 2006 - Volume 57 - Issue 4 - p 361-365 doi: 10.1097/01.sap.0000222569.59581.d9 Buy Metrics AbstractIn Brief The reconstruction of breast and upper-body deformities in massive weight loss (MWL) patients presents specific challenges to the plastic surgeon. In addition to significant breast ptosis and loss of breast volume, bariatric patients also have excessive lateral axillary and posterior truncal tissue that may require dermolipectomy for correction. A Wise-pattern mastopexy was designed with a pedicled fasciocutaneous flap based on the intercostal artery perforators (ICAP) to correct breast ptosis, to restore breast volume, and to eliminate redundant upper truncal tissue. Five MWL patients underwent mastopexy with ICAP flap augmentation. All patients had stable and esthetically pleasing results 1, 3, and 6 months postoperatively. There were no complications of infection, wound dehiscence, seroma, or hematoma. Furthermore, there was no evidence of flap loss or tissue necrosis. Mastopexy with autologous augmentation using the ICAP flap was found to be a reliable method of breast reconstruction in the MWL patient. Five massive weight loss patients underwent Wise pattern mastopexy with autologous augmentation using the intercostal artery perforator flap from the lateral breast and upper abdominal area. Appropriate bulk and contour were restored, and no complications or flap losses were seen. © 2006 Lippincott Williams & Wilkins, Inc.