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The Lateral Thigh Perforator Flap For Breast Reconstruction: A Clinical Series
Katzel, EB; Maricevich, M; Bykowski, MR; Schusterman MA II; Gimbel, ML
UPMC
2017-01-25
Presenter: Evan Katzel
Affidavit:
This is original work created by the authors of the presentation
Director Name: Vu T. Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
INTRODUCTION
Abdominally based flaps remain first choice for autologous breast reconstruction. However, alternative donor sites are necessary when the abdomen is unavailable. Numerous alternative donor sites have been proposed, however many of these sites are plagued by difficult harvest, poor donor site healing, and the need for position change. We previously presented CT angiogram analysis showing the feasibility of the lateral thigh perforator for alternative donor site flap harvest. Here, we present a series of 9 lateral thigh perforator (LTP) flaps designed based on CTA preoperative planning.
METHODS
Our center's standard DIEP imaging protocol was performed in all patients preoperatively. Flap orientation and harvest was planned based on these scans. Data on pedicle length, flap dimensions, flap mass were collected for 9 LTP flaps performed in 6 patients.
RESULTS
For our patient series, the average age was 63.5+/-9.0 years. The mean flap size was 164.0+/-33.7 cm2, and flaps weighed a mean of 439.1+/-99.5 grams. The mean pedicle length 5.94+/-0.9 cm; however, the dissectible pedicle was often longer. Pedicle lengths were often intentionally shorter to avoid vessel size mismatch with the internal mammary vessels during microvascular anastomosis.
CONCLUSIONS
Lateral thigh perforators are consistent and dependable on CTA analysis and in clinical practice. Preoperative imaging and flap planning with reliable landmarks are important for successful LTP harvest. We believe the LTP represents a reasonable alternative for select patients undergoing autologous breast reconstruction.
