Hospital San Martin La Plata University, Argentina.
Hospital San Martín University of Buenos Aires School of Medicine, Argentina.
J Plast Reconstr Aesthet Surg. 2023 Sep;84:157-164. doi: 10.1016/j.bjps.2023.05.042. Epub 2023 May 24.
The traditional donor sites for autologous breast reconstruction include the abdomen, thigh, buttock, and posterior thorax. Herein, we describe the use of the reverse lateral intercostal perforator (LICAP) flap originating from the submammary region as an option for breast reconstruction.
Fifteen patients (30 breasts) were included in this retrospective review. The procedure was performed for immediate reconstruction following a nipple sparing mastectomy utilizing an inframammary incision or an inverted T pattern with preservation of the fifth anterior intercostal perforator (n = 8), volume replacement after implant explantation (n = 5), and partial lower pole resurfacing with exteriorization of a portion of the LICAP skin paddle (n = 2).
Flap survival was achieved in all patients. Three flaps (10%) had 1-2 cm of intraoperative distal tip ischemia, which was managed by excision prior to inset and closure. At the 12-month postoperative follow-up, stable results with good nipple position, breast shape, and projection were achieved in all patients.
The reverse LICAP flap is a safe, effective, and reliable option for breast reconstruction following mastectomy.
自体乳房重建的传统供区包括腹部、大腿、臀部和后胸部。在此，我们描述了一种源自乳房下区域的肋间外侧穿支皮瓣（LICAP）的使用，作为乳房重建的一种选择。
本回顾性研究纳入了 15 名患者（30 个乳房）。该手术是在保留第五前肋间穿支（n=8）的情况下，通过乳晕下切口或倒 T 形切口进行保乳手术后即刻重建，或在假体取出后进行体积置换（n=5），或通过外部化部分 LICAP 皮瓣进行部分下极修复（n=2）。
所有患者的皮瓣均存活。3 个皮瓣（10%）在术中出现 1-2cm 的远端尖端缺血，通过切除后再植和关闭进行处理。在术后 12 个月的随访中，所有患者均获得了稳定的结果，乳头位置、乳房形状和突出度良好。
对于乳房切除术后的乳房重建，反向 LICAP 皮瓣是一种安全、有效和可靠的选择。
