A Novel Axillary Artery Cutaneous Artery Perforator Flap for Partial Breast Reconstruction

Excerpt

With better understanding of vascular anatomy and mapping of angiosomes and perforasomes, flaps used to fill defects after breast conservation surgery have evolved [1]. Volume replacement of partial mastectomy defects with mini-LD flaps is no more the only available option in the era of perforator flaps [2‐7]. Hamdi et al. are credited with the first description of partial breast reconstruction with flaps based on cutaneous perforators, arising from the anterior and posterior intercostal arteries [8, 9]. The lateral intercostal artery perforator (LICAP) has been used for lateral breast defects while anterior intercostal artery perforators (AICAP) have been used effectively in filling defects in the lower central and medial half of the breast. Subsequently, the lateral thoracic artery perforator (LTAP) was described by McCulley S. J. et al., which on its own or as a supplement to the lateral intercostal artery perforator could allow lateral breast defects to be reconstructed [10]. The discovery of these perforators with their versatility to reach various parts of the breast without sacrificing the latissimus dorsi muscle has opened up robust options for breast reconstruction. A novel axillary artery cutaneous artery perforator (AACAP) is described here; it allows replacement of defects of the outer half of the breast by itself or in combination with the LTAP. …