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Local Flaps for Volume Replacement

Local flaps restore breast volume after lumpectomy.

Summary

Lumpectomy can create a significant indentation in the breast, particularly in small-breasted individuals. Many do not have enough surrounding tissue to redistribute during lumpectomy (oncoplastic closure) to prevent contour abnormalities in the breast after surgery. Fortunately, surgeons can use natural tissue flaps from the surrounding chest wall to fill the area removed during lumpectomy and restore breast contour.

Types of Local Flaps for Volume Replacement Procedures

TDAP Flap

This flap elevates skin and fat from the back, making it a good option for lumpectomy defects on the side of the breast. It can also help correct more central irregularities. It is among the larger local flaps.

ICAP Flaps

These flaps are ideal for addressing inner, lower, and outer breast defects.

LTAP Flap

This flap is a good option for concavities along the outer portion of the breast.

Procedure Details:

  • Before surgery, the patient is marked in the standing position
  • A breast surgeon performs the lumpectomy
  • A plastic surgeon elevates and transfers the local flap to the lumpectomy site after the lumpectomy is complete
  • The plastic surgeon shapes the flap and secures it in place
  • The breast and the flap donor site are closed

Risks & Benefits

Local flaps are often ambulatory procedures, meaning that patients can go home on the same day. These options allow patients with smaller breasts to choose breast conservation therapy while easing issues with breast contour.

Some flaps require incisions that extend beyond the breast. All natural tissue flaps require care and expertise to ensure that their blood supply is preserved. It is essential to choose a surgeon who is experienced in this highly specialized area of plastic surgery.