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Utility of Two Surgical Techniques Using a Lateral Intercostal Artery Perforator Flap after Breast-Conserving Surgery: A Single-Center Retrospective Study

Kim, Jae Bong, M.D., Ph.D.; Eom, Jeung Ryeol, M.D.; Lee, Jeong Woo, M.D., Ph.D.; Lee, Jeeyeon, M.D., Ph.D.; Park, Ho Yong, M.D., Ph.D.; Yang, Jung Dug, M.D., Ph.D.

Plastic and Reconstructive Surgery: March 2019 - Volume 143 - Issue 3 - p 477e-487e
doi: 10.1097/PRS.0000000000005374
Breast: Original Articles
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Background: Immediate partial breast reconstruction after breast-conserving surgery has become a new paradigm in treating breast cancer. Among the volume replacement techniques used for small to moderate-sized breasts, the perforator flap method has many advantages. The authors present anatomical studies and two surgical techniques using lateral intercostal artery perforator flaps.

Methods: Data from 40 patients who underwent breast reconstruction using the lateral intercostal artery perforator flap between January of 2011 and June of 2016 were included. The authors conducted comparative analyses of the propeller flap and the turnover flap. They used three-dimensional computed tomography in lateral intercostal artery perforator flap anatomical studies, analyzing the distribution probability of the dominant perforator, the vertical distance from the axillary fold, and the horizontal distance from the anterior border of the latissimus dorsi.

Results: The most dominant perforator used for lateral intercostal artery perforator flaps was the sixth lateral intercostal artery perforator (43.6 percent of cases), followed by the seventh lateral intercostal artery perforator (39.1 percent of cases); their mean distances from the latissimus dorsi and the axillary folds were determined and reported. Complications included three cases requiring additional treatment for fat necrosis (propeller method, two cases; turnover method, one case) and venous congestion in only two cases that used the propeller method. Cosmetic satisfaction was 90 percent or greater for both techniques, indicating that results were rated as either excellent or good.

Conclusion: The authors believe that their study results can broaden the application of partial breast reconstruction by using the lateral intercostal artery perforator flap after breast-conserving surgery, with three-dimensional computed tomography for anatomical studies, and using one of the authors’ two described surgical techniques.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Daegu, Republic of Korea

From the Departments of Plastic and Reconstructive Surgery and Surgery, School of Medicine, Kyungpook National University.

Received for publication December 27, 2017; accepted July 11, 2018.

Disclosure:The authors have no financial interest to declare in relation to the content of this article.

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Jung Dug Yang, M.D., Ph.D., Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, 130 Dongdeok-ro, Daegu 41944, Republic of Korea, lambyang@knu.ac.kr

Copyright © 2019 by the American Society of Plastic Surgeons