Preservation of Aesthetics of Breast in Pectoralis Major Myocutaneous Flap Donor Site in Females

J Maxillofac Oral Surg. 2016 Jun;15(2):268-71. doi: 10.1007/s12663-015-0820-3. Epub 2015 Jul 29.

Abstract

Background and objectives: In females, raising a pectoralis major myocutaneous flap is challenging and primary closure of flap donor site causes breast deformity with medial displacement of nipple areola complex. To avoid this distortion, a new method of donor site closure is devised.

Methods: A parasternal skin paddle which has better vascularity is planned while doing a pectoralis major myocutaneous flap in females and a lateral flap planned along the lateral breast curve is used to cover the donor site. The lateral flap donor site is primarily closed. This prevents medial displacement of nipple areola complex.

Results: A total of 47 patients underwent donor site flap closure technique. Minor complications in form of marginal necrosis near the tip of the flap were observed in 10.6 % patients. The donor breast of all these PMMC flaps had good contour and aesthetic positioning of nipple areola complex.

Conclusion: Donor site morbidity with respect to breast distortion has not been studied so far in case of females so our study stands unique in this aspect. Using this technique of planning PMMC in females ensures a skin paddle of better vascularity and restores the breast aesthetics.

Keywords: Bipaddled PMMC flap; Buccal mucosa cancer; Oral cancer; PMMC in females; Reconstruction.