Treatment of breast deformity with free deep inferior epigastric perforator flap secondary to pectoralis major flap harvesting

Kuang-Ling Ou, Tim-Mo Chen, Nian-Tzyy Dai, Shun-Cheng Chang, Shou-Cheng Deng, Yuan-Sheng Tzeng, Chih-Hsin Wang, Shyi-Gen Chen

Research output: Contribution to journalArticlepeer-review


Head and neck cancer is less common in women than in men. Free tissue transfer is the first choice in reconstructive option for head and neck tumor. Pedicle pectoralis major (PM) flap was a common option in head neck reconstruction in the past, but has become the salvage procedure when free flap fails. However, it is not suitable for female patients because of severe breast deformity and induced psychosocial distress. We present a female patient who had breast deformity due to PM flap reconstruction and was successfully treated with free deep inferior epigastric perforator (DIEP) flap. A 48-year-old woman had squamous cell carcinoma in the left side buccal mucosa, T2N0M0, stage II s/p wide excision with partial resection of maxilla and marginal resection of mandible. Free anterolateral thigh flap had been tried but in vain, then alternatively salvaged with a pedicle PM flap 3 years earlier. She presented with malposition of the left breast, nipple retraction, and high riding. We adequately released the contracture and reconstructed with a free DIEP flap. The free DIEP flap survived completely and restored a balanced breast with good shape and symmetry at 1-year follow-up. Although PM flap is a good modality in head and neck reconstruction, it should be used cautiously especially in female patients. The free DIEP flap is not only suitable for breast reconstruction in breast cancer patient, but also a good choice for a different purpose of breast reconstruction such as this patient with breast deformity due to PM flap harvest. © 2013.
Original languageEnglish
Pages (from-to)32-35
Number of pages4
JournalFormosan Journal of Surgery
Issue number1
Publication statusPublished - 2014
Externally publishedYes


  • Deep inferior epigastric perforator flap
  • Head and neck cancer
  • Pectoralis major flap
  • adult
  • anterolateral thigh flap
  • article
  • body image
  • breast malformation
  • breast reconstruction
  • cancer staging
  • case report
  • cheek mucosa
  • deep inferior epigastric perforator flap
  • Doppler flowmetry
  • female
  • follow up
  • human
  • mandible resection
  • mental stress
  • middle aged
  • nipple malformation
  • pectoralis major muscle
  • pedicled skin flap
  • priority journal
  • rectus abdominis muscle
  • squamous cell carcinoma
  • wide excision


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