Fasciae latae perforator flap for breast reconstruction: An attractive alternative in case of DIEP contraindication

• Published in: Annales de chirurgie plastique et esthétique Vol. 62; no. 1; pp. 97 - 103
• Main Authors: Lefèvre, M, Sarfati, B, Honart, J-F, Alkashnam, H, Rimareix, F, Leymarie, N, Kolb, F
• Format: Journal Article
• Language: English; French
• Published: France 01.02.2017
• Subjects: Breast Neoplasms - surgery; Fascia Lata - transplantation; Female; Humans; Mammaplasty - methods; Mastectomy - methods; Middle Aged; Patient Satisfaction; Perforator Flap - adverse effects; Perforator Flap - pathology; Retrospective Studies; Treatment Outcome; Lambeau perforant septo-cutané; Septo-cutaneous perforator flap; Breast reconstruction; Reconstruction mammaire; Free flap; Lambeau tenseur de fascia latae; Autologous reconstruction; Tensor fascia latae flap; Reconstruction autologue; Lambeau libre
• ISSN: 1768-319X
• DOI: 10.1016/j.anplas.2016.05.011

The musculocutaneous tensor fascia latae flap was one of the first free flaps described. It is possible to harvest a flap with the same skin paddle, vascularized by a septo-cutaneous perforator running through the tensor fascia lata muscle septum and coming from the ascending branch of the lateral circumflex femoral artery. The DIEP is currently the workhorse of autologous breast reconstruction, but there are some contraindications. The septo-cutaneous tensor fascia latae perforator flap may be an alternative for women with lateral upper thigh lipodystrophy. Between 2010 and 2014, three flaps have been performed in two patients for delayed breast reconstruction (one case of unilateral reconstruction, and one bilateral). Perforators were identified by preoperative angiography. The intervention was performed in a two-team approach, in only one operative position. Perforators were located in the horizontal axis of the upper rim of the pubis bone. One perforator artery was dissected for each flap. The mean caliber of the pedicle was 2.8mm, and the mean length was 6.4cm. The operative time was 240minutes for unilateral flap, 375minutes for bilateral flap. There was no case of total or partial necrosis, or complications on the donor site. Cosmetic results were considered satisfying by patients and surgeons with the reconstructed breast as well as the donor site. Septo-cutaneous fascia lata perforator flap is an attractive flap for breast reconstruction in patients with DIEP contraindication and lateral upper thigh lipodystrophy. It has many advantages: easy to harvest, length and calibre of the pedicle, double team approach, only one operating position, quality of reconstruction. It is necessary to carry out a larger series of cases to study the complication rate in the donor site.