title: Partial breast reconstruction for the medial quadrants using the omental flap.
abstract: BACKGROUND
  The indications for breast-conserving surgery have increased due to the establishment of various volume-replacement techniques. We have used the omental flap for partial breast reconstruction. Unlike other autologous flaps, the medial quadrants represent a suitable field for the omental flap. We report a technique for partial breast reconstruction using the omental flap.
  
  
  METHODS
  For tumors in the lower medial quadrant, wide excision was performed through an inframammary skin incision. The omental flap was harvested laparoscopically, and a subcutaneous tunnel was created towards the xyphoid process. The omental flap was extracted through the tunnel and used to fill the defect directly. For tumors in the upper medial quadrant, a periareolar incision was usually used for wide excision, and an additional small inframammary incision was made to extract the omental flap. The pedicle of the flap was made as slim as possible by defatting, and the subcutaneous fat tissue around the tunnel was excised to avoid bulging caused by the subcutaneous tunnel.
  
  
  RESULTS
  A total of 51 patients with tumors in the medial quadrants underwent partial breast reconstruction with the omental flap between April 2002 and July 2013. The surgical margin was positive in two patients, and there was only one case of local recurrence. The complication rate was 7.8 %, and all of them were minor. Cosmetic results were mostly satisfactory with minimal donor-site scars.
  
  
  CONCLUSIONS
  The omental flap is an attractive volume replacement technique for difficult quadrants of the breast with minimal donor-site morbidities and deformities.
authors: Department of Breast Surgery, Nakagami Hospital, Okinawa, Japan, hisamitu@nakagami.or.jp.
authors: Hisamitsu
authors: H
authors: Zaha
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty; D008408:Mastectomy; D009367:Neoplasm Staging; D009852:Omentum / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D013524:Surgical Flaps