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Lateral Intercostal Artery Perforator Flap: A Single Surgeon Experience and Review of the Literature for Partial Breast Reconstruction

Zoe M MacIsaac, Chelsey Johnson, Ryan Bram, Carolyn De La Cruz, Michael L Gimbel
UPMC
2019-02-15

Presenter: Zoe M MacIsaac

Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The program director is responsible for making a statement within the confines of the box below specific to how much of the work on this project represents the original work of the resident. All authors/submitters of each abstract should discuss this with their respective program director for accurate submission of information as well as the program director's approval for inclusion of his/her electronic signature.

Director Name: Vu Nguyen

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)

Background: The lateral intercostal artery perforator (LICAP) flap was first described by Holmstrom et al in 1986 as an option for superolateral breast reconstruction. Subsequently, numerous articles have described the flap and its variations, however a review of the literature has yet to be published. Here we present our experience and review of the literature.

Methods: A retrospective review was conducted of a single surgeon's experience a major university center. Patients who underwent LICAP flaps between the years of 2007-2018 were included. A literature review was performed using Pubmed search terms "lateral intercostal artery perforator flap" and "lateral thoracodorsal flap" and selecting articles describing use of this flap for partial breast reconstruction.

Results: 11 patients underwent LICAP flaps for partial breast reconstruction. Average age was 55. Diagnosis included ductal carcinoma in situ and invasive carcinoma, and wound secondary to radiation therapy. Excision volume ranged from to 3x4x2cm to 6x6x5cm, from the superolateral breast. Most reconstructions were delayed. No seromas, no delayed healing, nor need for operative revision were observed.
From our literature search, 127 articles were identified, of which 35 included pertinent information on 389 patients (age range 37-74 years.) Complication rates were low, with one failure reported. The majority of aesthetic outcomes were reported good to excellent.

Conclusion: The LICAP flap presents a robust option for reconstruction of superolateral partial mastectomy defects. It may be performed in a delayed fashion to ensure negative margins at time of reconstruction, and achieves good aesthetic outcomes with low risk of complications.

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