Department of Plastic Surgery, California-Pacific Medical Center, San Francisco, California, USA.
J Reconstr Microsurg. 2011 Sep;27(7):427-32. doi: 10.1055/s-0031-1281527. Epub 2011 Jul 15.
The development of microsurgical breast reconstruction has resulted in not only the lower abdomen as a source of donor site tissue but also interest in alternative donor sites. These have included perforator-based flaps at the sites of previously described myocutaneous flaps (e.g., superior or inferior gluteal arteries) and the use of myocutaneous flaps not previously used for breast reconstruction (e.g., gracilis or transverse upper gracilis). We present our experience with a unique form of the tensor fascia lata flap and describe the first reported use of the lateral femoral circumflex artery (LFCA) perforator flap for breast reconstruction. A patient with minimal abdominal fat but lipodystrophy of the upper lateral thighs presented for breast reconstruction. Perforator flaps based on the lateral femoral circumflex vessels were designed. The LFCA perforator flap from one side was successfully used for breast reconstruction. The flap on the contralateral side did not have a suitable perforator. The LFCA perforator flap offers another option for women seeking autogenous breast reconstruction. Advances in preoperative imaging will likely make this a more reliable option.
微创手术乳房重建的发展不仅使下腹部成为供区组织的来源，也引起了对替代供区的兴趣。这些包括先前描述的肌皮瓣（例如，臀上或臀下动脉）部位的基于穿支的皮瓣，以及先前未用于乳房重建的肌皮瓣（例如，股薄肌或横形股薄肌）的使用。我们介绍了一种独特形式的阔筋膜张肌皮瓣的经验，并描述了首例用于乳房重建的旋股外侧动脉（LFCA）穿支皮瓣的应用。一位患者腹部脂肪很少，但上外侧大腿脂肪营养不良，前来进行乳房重建。设计了基于股外侧旋骼血管的穿支皮瓣。一侧的 LFCA 穿支皮瓣成功用于乳房重建。对侧的皮瓣没有合适的穿支。LFCA 穿支皮瓣为寻求自体乳房重建的女性提供了另一种选择。术前影像学的进步可能使这成为更可靠的选择。
