title: Immediate reconstruction using free medial circumflex femoral artery perforator flaps after breast-conserving surgery.
abstract: Recent advances in perforator flap surgical techniques have allowed for safe and reliable autologous tissue transfer with minimal donor-site morbidity. Between April 2012 and January 2013, we performed immediate breast reconstruction using free medial circumflex femoral artery perforator (MCFAP) flaps in 15 patients after breast-conserving surgery. The flaps were harvested from patients in the lithotomy position, while a second surgical team simultaneously conducted tumour resection. Of the 15 procedures performed, three flaps were dissected as true perforator flaps, while 12 flaps were dissected as muscle-sparing perforator flaps. The mean flap weight was 138.5 g (range, 77-230 g) and the mean pedicle length was 5.7 cm (range, 3.0-9.0 cm). Recipient vessels for anastomosis were serratus branches in 10 patients, internal mammary vessels in three patients and thoracodorsal vessels in two patients. The mean duration of surgery was 6.74 h (range, 5.65-9.45 h). There were no major complications requiring surgical intervention. Researchers observed partial flap necrosis, which manifested as small firm lesions in two patients, as well as local wound infection and dehiscence in one patient, which resolved spontaneously. There were no instances of donor-site seroma formation or lymphoedema in any of the patients. An objective assessment of postoperative photographs showed that cosmetic results were mostly satisfactory. Donor-site scars along the medial groin crease were inconspicuous and readily concealed by clothing. Given its reliable vascularity and minimal donor-site morbidity, the free MCFAP flap can be a good alternative for partial breast reconstruction after breast-conserving surgery.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Osaka General Medical Center, Osaka, Japan. Electronic address: ken0503@taurus.zaq.jp.
authors.forename: Ken
authors.initials: K
authors.lastname: Izumi
authors.forename: Masakazu
authors.initials: M
authors.lastname: Fujikawa
authors.forename: Hiroki
authors.initials: H
authors.lastname: Tashima
authors.forename: Takuya
authors.initials: T
authors.lastname: Saito
authors.forename: Yohei
authors.initials: Y
authors.lastname: Sotsuka
authors.forename: Koichi
authors.initials: K
authors.lastname: Tomita
authors.forename: Ko
authors.initials: K
authors.lastname: Hosokawa
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006119:Groin / Q000601:surgery; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D015412:Mastectomy, Segmental; D008875:Middle Aged; D061646:Operative Time; D061525:Perforator Flap / Q000009:adverse effects / Q000098:blood supply; D013997:Time Factors; D060053:Transplant Donor Site / Q000098:blood supply / Q000601:surgery*
keywords: Breast reconstruction; Breast-conserving surgery; Medial circumflex femoral artery perforator flap; Transverse gracilis musculocutaneous flap