Bilateral free posteromedial thigh perforator flaps for unilateral breast reconstruction

Abstract

Objective To explore the clinical application of bilateral free posteromedial thigh perforator flaps for unilateral breast reconstruction. Methods Retrospective analysis of bilateral free posteromedial thigh perforator flaps application in six breast cancer cases for immediate or two-staged breast reconstruction. The age of patients ranged from 31 to 47 years old. All cancer occurred in hemi-lateral, 3 cases on left and 3 cases on right. Pathological diagnosis included invasive ductal carcinoma in 3 cases and invasive lobular carcinoma in 3 cases. One or two-staged breast reconstruction using bilateral free posteomedial thigh perforator flaps was carried out in 6 breast cancer patients. In stage Ⅰ cases the breast tumor size ranged from 2.5 to 4.0 cm, (2.8±0.5) cm on average; 3 cases of breast cancer were in stage Ⅰ and 3 cases was in stage Ⅱ. Postoperative follow-up of recipient and donor sites were evaluated. Results The length of flap was (24.4±0.5) cm, the width of flap was (8.3±0.5) cm, the thickness of flap was (3.4±0.5) cm. The length of pedicle was (8.9±0.4) cm, the outer diameter of pedicle artery was (1.5±0.4) mm, the outer diameter of pedicle vein was (1.9±0.3) mm. The average weight of flap was 235 g (ranged from 165 g to 345 g). Lymphatic leakage occurred in the donor site in 1 case 1 week postoperatively and healed with continuous negative pressure suction in 2 weeks. All flaps survived totally. The reconstructed breasts’ shape, texture and elasticity were good and no flap contracture deformation happened. Only linear scar left in the donor sites, the function of thighs was not affected. All 6 patients were followed up for 5-8 months (5.5 months on average) with satisfied result. No local recurrence happened. Conclusions Bilateral free posteromedial thigh perforator flaps transferring is feasible to reconstruct unilateral breast. Key words: Breast Neoplasms; Perforator flap; Posteromedial thigh perforator; Breast reconstruction