Total breast reconstruction using chest wall perforator flaps combined with oncoplastic techniques

Abstract

Total breast reconstruction (TBR) for patients unsuitable for traditional autologous free flap or implant-based reconstruction methods poses a significant challenge. This case series explores novel approaches using chest wall perforator flaps (CWPF) combined with other oncoplastic techniques to achieve TBR. From 2022 to 2024, we managed nine mastectomy patients and one patient with isolated congenital amazia with CWPFs alone or combined with one of the following: Golidilocks mastectomy and extended CWPF, multiple CWPFs, fat grafting, and implant-based reconstruction. All patients achieved satisfactory outcomes with minimal complications and no flap loss. CWPFs combined with oncoplastic techniques are a viable strategy in select patients that are ineligible for, or have preferences against, more common methods of reconstruction. Combined oncoplastic techniques provide versatile reconstructive options that can be personalized to individual patients.