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 journalArticle

Abstract

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
Volume47
Issue number1
DOIs
Publication statusPublished - 2014
Externally publishedYes

Fingerprint

Perforator Flap
Breast
Mammaplasty
Head
Neck
Therapeutics
Nipples
Free Tissue Flaps
Mouth Mucosa
Maxilla
Contracture
Head and Neck Neoplasms
Thigh
Mandible
Squamous Cell Carcinoma
Breast Neoplasms
Neoplasms

Keywords

  • 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

Cite this

Treatment of breast deformity with free deep inferior epigastric perforator flap secondary to pectoralis major flap harvesting. / Ou, Kuang-Ling; Chen, Tim-Mo; Dai, Nian-Tzyy; Chang, Shun-Cheng; Deng, Shou-Cheng; Tzeng, Yuan-Sheng; Wang, Chih-Hsin; Chen, Shyi-Gen.

In: Formosan Journal of Surgery, Vol. 47, No. 1, 2014, p. 32-35.

Research output: Contribution to journalArticle

Ou, Kuang-Ling ; Chen, Tim-Mo ; Dai, Nian-Tzyy ; Chang, Shun-Cheng ; Deng, Shou-Cheng ; Tzeng, Yuan-Sheng ; Wang, Chih-Hsin ; Chen, Shyi-Gen. / Treatment of breast deformity with free deep inferior epigastric perforator flap secondary to pectoralis major flap harvesting. In: Formosan Journal of Surgery. 2014 ; Vol. 47, No. 1. pp. 32-35.
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abstract = "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. {\circledC} 2013.",
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author = "Kuang-Ling Ou and Tim-Mo Chen and Nian-Tzyy Dai and Shun-Cheng Chang and Shou-Cheng Deng and Yuan-Sheng Tzeng and Chih-Hsin Wang and Shyi-Gen Chen",
note = "Export Date: 21 March 2016 通訊地址: Chen, S.-G.; Division of Plastic Surgery, Department of Surgery, Tri-Service General Hospital, 325, Section 2, Cheng-Kung Road, Nei-Hu 114, Taipei, Taiwan; 電子郵件: shyigen@gmail.com 參考文獻: El-Marakby, H.H., The reliability of pectoralis major myocutaneous flap in head and neck reconstruction (2006) J Egypt Natl Canc Inst, 18, pp. 41-50; Lui, H.L., Chan, J.Y., Wei, W.I., The changing role of pectoralis major flap in head and neck reconstruction (2010) Eur Arch Otorhinolaryngol, 267, pp. 1759-1763; Huang, S., Liu, H.E., Effectiveness of cosmetic rehabilitation on the body image of oral cancer patients in Taiwan (2008) Support Care Cancer, 16, pp. 981-986; Chang, D.W., Breast reconstruction with microvascular MS-TRAM and DIEP flaps (2012) Arch Plast Surg, 39, pp. 3-10; Feng, C.H., Cheng, M.H., Ulusal, B.G., Simultaneous contralateral breast reduction with breast reconstruction using dIEP/ SIEA flap (2006) J Plast Surg Asso ROC, 15, pp. 315-321; Lee, T.P., Chen, S.G., Reconstruction of female Poland Syndrome with de-epithelialized pedicled transverse rectus abdominis myocutaneous flap (2007) J Plast Surg Assoc ROC, 16, pp. 232-240; Tachi, M., Yamada, A., Choice of flaps for breast reconstruction (2005) Int J Clin Oncol, 10, pp. 289-297",
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T1 - Treatment of breast deformity with free deep inferior epigastric perforator flap secondary to pectoralis major flap harvesting

AU - Ou, Kuang-Ling

AU - Chen, Tim-Mo

AU - Dai, Nian-Tzyy

AU - Chang, Shun-Cheng

AU - Deng, Shou-Cheng

AU - Tzeng, Yuan-Sheng

AU - Wang, Chih-Hsin

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N1 - Export Date: 21 March 2016 通訊地址: Chen, S.-G.; Division of Plastic Surgery, Department of Surgery, Tri-Service General Hospital, 325, Section 2, Cheng-Kung Road, Nei-Hu 114, Taipei, Taiwan; 電子郵件: shyigen@gmail.com 參考文獻: El-Marakby, H.H., The reliability of pectoralis major myocutaneous flap in head and neck reconstruction (2006) J Egypt Natl Canc Inst, 18, pp. 41-50; Lui, H.L., Chan, J.Y., Wei, W.I., The changing role of pectoralis major flap in head and neck reconstruction (2010) Eur Arch Otorhinolaryngol, 267, pp. 1759-1763; Huang, S., Liu, H.E., Effectiveness of cosmetic rehabilitation on the body image of oral cancer patients in Taiwan (2008) Support Care Cancer, 16, pp. 981-986; Chang, D.W., Breast reconstruction with microvascular MS-TRAM and DIEP flaps (2012) Arch Plast Surg, 39, pp. 3-10; Feng, C.H., Cheng, M.H., Ulusal, B.G., Simultaneous contralateral breast reduction with breast reconstruction using dIEP/ SIEA flap (2006) J Plast Surg Asso ROC, 15, pp. 315-321; Lee, T.P., Chen, S.G., Reconstruction of female Poland Syndrome with de-epithelialized pedicled transverse rectus abdominis myocutaneous flap (2007) J Plast Surg Assoc ROC, 16, pp. 232-240; Tachi, M., Yamada, A., Choice of flaps for breast reconstruction (2005) Int J Clin Oncol, 10, pp. 289-297

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N2 - 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.

AB - 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.

KW - Deep inferior epigastric perforator flap

KW - Head and neck cancer

KW - Pectoralis major flap

KW - adult

KW - anterolateral thigh flap

KW - article

KW - body image

KW - breast malformation

KW - breast reconstruction

KW - cancer staging

KW - case report

KW - cheek mucosa

KW - deep inferior epigastric perforator flap

KW - Doppler flowmetry

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KW - follow up

KW - human

KW - mandible resection

KW - mental stress

KW - middle aged

KW - nipple malformation

KW - pectoralis major muscle

KW - pedicled skin flap

KW - priority journal

KW - rectus abdominis muscle

KW - squamous cell carcinoma

KW - wide excision

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JO - Formosan Journal of Surgery

JF - Formosan Journal of Surgery

SN - 1011-6788

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