urgical reconstruction of soft-tissue defects in the knee, popliteal fossa, and upper lower leg area is a challenging task. One has to not only restore an aesthetic appearance but also enable proper function. Because of the limited availability and mobility of the adjacent skin, defects involving these areas often require complex reconstruction procedures.Many techniques, such as skin grafting, local skin flaps, pedicled muscle flaps, and free flaps, have already been described for the reconstruction of these regions; however, these regions should optimally be repaired using thin and pliable flaps. Based on basic plastic surgery principles to replace "like with like" with minimal donor-site morbidity and without sacrificing a major vessel, perforator flaps designed from the medial calf area represent a viable option. In particular, the medial sural artery perforator flap, which is harvested from this region, is therefore ideal for the
Abstrct Consecutive or simultaneous contralateral breast reduction is a frequent request from patients undergoing unilateral breast reconstruction. Both procedures can be combined using otherwise discarded tissue as a split breast graft for reconstruction of the contralateral side. There have been few reports on the use of pedicled split breast grafts. We present a 75‐year‐old female with multicentric mammary carcinoma following chemotherapy, mastectomy, axillary lymph node dissection and radiotherapy. She requested a reconstruction of the left breast as well as reduction of the right breast. Risk factors, including heavy alcohol and tobacco dependence and COPD, limited the surgical options. While a free flap breast reconstruction was the standard feasible option, we opted for a procedure with minimal surgery‐related morbidity. The right breast was evidently tumor‐free, and the patient had no family history of breast cancer. Reconstruction was performed 22 months postmastectomy. The split‐breast free flap was based on the right internal mammary artery (IMA) perforator and harvested during the right‐sided breast reduction. Microsurgical anastomosis was performed on the IMA perforator on the left side. Mastopexy was performed on the right side and the nipple‐areola complex (NAC) was transferred to its new position as a free graft to complete the breast reduction. A tattoo of the left NAC was performed 4 months postreconstruction. There was complete flap survival with a pleasant cosmetic result. Split breast reconstruction could be an alternative to more common procedures. However, this approach is only feasible in patients with hypertrophic contralateral breast and absence of risk factors for developing a second primary breast cancer.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.