Filling the Upper Pole with the Pectoralis Major Muscle Flap in Profunda Femoris Artery Perforator Flap Breast Reconstruction

<i>Background and Objectives</i>: Among many donor site options for autologous breast reconstruction, the use of the profunda femoris artery perforator (PAP) flap has become common in patients who are not suitable for the gold standard procedure, the deep inferior epigastric artery perfo...

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Main Authors: Hidehiko Yoshimatsu, Hiroki Miyashita, Ryo Karakawa, Yuma Fuse, Tomoyuki Yano
Format: Article
Language:English
Published: MDPI AG 2022-03-01
Series:Medicina
Subjects:
Online Access:https://www.mdpi.com/1648-9144/58/4/458
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author Hidehiko Yoshimatsu
Hiroki Miyashita
Ryo Karakawa
Yuma Fuse
Tomoyuki Yano
author_facet Hidehiko Yoshimatsu
Hiroki Miyashita
Ryo Karakawa
Yuma Fuse
Tomoyuki Yano
author_sort Hidehiko Yoshimatsu
collection DOAJ
description <i>Background and Objectives</i>: Among many donor site options for autologous breast reconstruction, the use of the profunda femoris artery perforator (PAP) flap has become common in patients who are not suitable for the gold standard procedure, the deep inferior epigastric artery perforator flap. However, its limited volume has precluded its wide use in breast reconstruction. The aim of this report was to demonstrate the effectiveness of a method in which the anatomical position of the pectoralis major muscle was adjusted to augment the volume of the superior pole of the breast during PAP flap transfer. A comparison was made with a conventional PAP flap breast reconstruction. <i>Materials and Methods</i>: Fifty-nine consecutive cases where unilateral autologous breast reconstruction was performed using the vertically designed PAP flap were retrospectively reviewed. Conventional PAP flap transfer was performed in 36 patients (Group 1), and PAP flap transfer with pectoralis major muscle augmentation was performed in 23 patients (Group 2). <i>Results</i>: The patient satisfaction at 12 months postoperatively was statistically greater in Group 2, with the pectoralis major muscle augmentation, than in Group 1 [23/36 (64%) vs. 22/23 (96%), <i>p</i> = 0.005]. There were no significant differences in postoperative complication rates at the reconstructed site [2/36 (5.6%) vs. 0/23 (0%), <i>p</i> = 0.52]. <i>Conclusions</i>: Higher patient satisfaction could be achieved with pectoralis major muscle augmentation in PAP flap breast reconstruction without increasing the postoperative complication rate at the reconstructed site.
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spelling doaj.art-752ca54fda3547bba85e94d639775dcc2023-12-03T13:40:54ZengMDPI AGMedicina1010-660X1648-91442022-03-0158445810.3390/medicina58040458Filling the Upper Pole with the Pectoralis Major Muscle Flap in Profunda Femoris Artery Perforator Flap Breast ReconstructionHidehiko Yoshimatsu0Hiroki Miyashita1Ryo Karakawa2Yuma Fuse3Tomoyuki Yano4Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, JapanDepartment of Plastic and Reconstructive Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, JapanDepartment of Plastic and Reconstructive Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, JapanDepartment of Plastic and Reconstructive Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, JapanDepartment of Plastic and Reconstructive Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan<i>Background and Objectives</i>: Among many donor site options for autologous breast reconstruction, the use of the profunda femoris artery perforator (PAP) flap has become common in patients who are not suitable for the gold standard procedure, the deep inferior epigastric artery perforator flap. However, its limited volume has precluded its wide use in breast reconstruction. The aim of this report was to demonstrate the effectiveness of a method in which the anatomical position of the pectoralis major muscle was adjusted to augment the volume of the superior pole of the breast during PAP flap transfer. A comparison was made with a conventional PAP flap breast reconstruction. <i>Materials and Methods</i>: Fifty-nine consecutive cases where unilateral autologous breast reconstruction was performed using the vertically designed PAP flap were retrospectively reviewed. Conventional PAP flap transfer was performed in 36 patients (Group 1), and PAP flap transfer with pectoralis major muscle augmentation was performed in 23 patients (Group 2). <i>Results</i>: The patient satisfaction at 12 months postoperatively was statistically greater in Group 2, with the pectoralis major muscle augmentation, than in Group 1 [23/36 (64%) vs. 22/23 (96%), <i>p</i> = 0.005]. There were no significant differences in postoperative complication rates at the reconstructed site [2/36 (5.6%) vs. 0/23 (0%), <i>p</i> = 0.52]. <i>Conclusions</i>: Higher patient satisfaction could be achieved with pectoralis major muscle augmentation in PAP flap breast reconstruction without increasing the postoperative complication rate at the reconstructed site.https://www.mdpi.com/1648-9144/58/4/458profunda femoris artery perforator flappectoralis muscle flapautologous breast reconstruction
spellingShingle Hidehiko Yoshimatsu
Hiroki Miyashita
Ryo Karakawa
Yuma Fuse
Tomoyuki Yano
Filling the Upper Pole with the Pectoralis Major Muscle Flap in Profunda Femoris Artery Perforator Flap Breast Reconstruction
Medicina
profunda femoris artery perforator flap
pectoralis muscle flap
autologous breast reconstruction
title Filling the Upper Pole with the Pectoralis Major Muscle Flap in Profunda Femoris Artery Perforator Flap Breast Reconstruction
title_full Filling the Upper Pole with the Pectoralis Major Muscle Flap in Profunda Femoris Artery Perforator Flap Breast Reconstruction
title_fullStr Filling the Upper Pole with the Pectoralis Major Muscle Flap in Profunda Femoris Artery Perforator Flap Breast Reconstruction
title_full_unstemmed Filling the Upper Pole with the Pectoralis Major Muscle Flap in Profunda Femoris Artery Perforator Flap Breast Reconstruction
title_short Filling the Upper Pole with the Pectoralis Major Muscle Flap in Profunda Femoris Artery Perforator Flap Breast Reconstruction
title_sort filling the upper pole with the pectoralis major muscle flap in profunda femoris artery perforator flap breast reconstruction
topic profunda femoris artery perforator flap
pectoralis muscle flap
autologous breast reconstruction
url https://www.mdpi.com/1648-9144/58/4/458
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