10 - Local Flap Techniques for Oncoplastic Breast Reconstruction

Abstract

Recently, standardization of population screening and advances in the diagnostic techniques have allowed detection of breast cancer in earlier stages, which means that at the moment of diagnosis the tumor generally has small dimensions. This fact allows performing the excision through breast-conserving therapy, the main purpose of which is to proceed to oncologic resection, meanwhile trying to maintain the maximum possible breast tissue. The standardization of this type of approach has a direct consequence, which is an increase in the number of patients with partial volumetric deficits. Recently, in plastic surgery we are facing more and more patients with this type of defect that, despite being partial, is a distorted aspect of the breast, with consequent psychosocial discomfort and improper perception of one’s own body image. Perforator free flaps are considered the gold standard technique for breast reconstruction, but local coverage options like pedicled flaps should not be underestimated, because their use has shown to be effective in women with lumpectomy and mastectomy sequelae. Local flaps for breast reconstruction are an essential therapeutic tool that allows expanding the spectrum of patients who can undergo immediate reconstruction and, in some cases, achieve the reconstruction of partial breast defects in patients who do not want or cannot undergo free tissue transfer. Therefore, we believe that breast reconstruction with local flaps can and should have a privileged place in the therapeutic arsenal of any plastic surgeon in cases where its use is indicated.