Preservation of Aesthetics of Breast in Pectoralis Major Myocutaneous Flap Donor Site in Females

Abstract

Background and Objectives In females, raising a pectoralis major myocutaneous flap is challenging and primary closure of flap donor site causes breast deformity with medial displacement of nipple areola complex. To avoid this distortion, a new method of donor site closure is devised. Methods A parasternal skin paddle which has better vascularity is planned while doing a pectoralis major myocutaneous flap in females and a lateral flap planned along the lateral breast curve is used to cover the donor site. The lateral flap donor site is primarily closed. This prevents medial displacement of nipple areola complex. Results A total of 47 patients underwent donor site flap closure technique. Minor complications in form of marginal necrosis near the tip of the flap were observed in 10.6 % patients. The donor breast of all these PMMC flaps had good contour and aesthetic positioning of nipple areola complex. Conclusion Donor site morbidity with respect to breast distortion has not been studied so far in case of females so our study stands unique in this aspect. Using this technique of planning PMMC in females ensures a skin paddle of better vascularity and restores the breast aesthetics.

Evaluating Pedicled Pectoralis Major Myocutaneous Flap Reconstructions for Oral Malignancy and the Influence of Laterally Based Rotational Advancement Flap on Donor Site Integrity and Nipple Position in Male Patients

“…This dog ear can be excised later as a minor procedure under local anesthesia. A similar concept of using the lateral part of breast skin was designed by Sandeep M. et al [12] for female patients to avoid distortion in female patients.…”

Advances in the application of common tissue flaps for the repair of oral and maxillofacial defects

“…In recent years, scholars have made many improvements in the preparation technology of PMMF, such as extending to the anterior axillary line [28] , crossing the subclavian bone [29] , ligation of lateral thoracic artery [30] , etc., in order to extend the radius of flap repair, skeletonizing the vascular pedicle [ [24] , and preserving the position of nipple areola and breast morphology [31] . Combined with other flaps, including free flaps [32] and folded double splicing [30] , it is used to repair large or penetrating defects, further expanding the indications of this flap.In patients with high lesion locations, mostly located in the zygatic region, temporal region and orbital region, sufficient vascular pedicle length is required to avoid postoperative complications caused by large local tension.…”