J Reconstr Microsurg 2003; 19(2): 063-068
DOI: 10.1055/s-2003-37807
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1 (212) 584-4662

Anterolateral Thigh Flap for Breast Reconstruction: Review of the Literature and Case Reports

Jonathan L. Kaplan, Robert J. Allen, Aldo Guerra, Scott K. Sullivan
  • Section of Plastic Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana
Further Information

Publication History

Publication Date:
10 March 2003 (online)

ABSTRACT

More women than ever before are undergoing mastectomies secondary to increased awareness and screening. This has also caused a corresponding increase in the number of breast reconstructions requested each year. The demand for improved results has fueled recent advances in new techniques. Aside from implant reconstruction, the methods now being employed are related to autogenous donations and reconstruction. Currently, the most commonly used techniques for autogenous breast reconstruction are the DIEP (deep inferior epigastric perforator) and TRAM (transverse rectus abdominis myocutaneous) flaps from the lower abdomen.

The anterolateral thigh flap is a type of perforator flap usually described for use in head and neck reconstruction. The authors have discovered this flap's utility as an alternative in autogenous breast reconstruction when the abdomen is not available as a donor site. A review of the literature reveals a dearth of experience in using the anterolateral thigh flap for breast reconstruction. The article reviews the literature with regard to current uses of the anterolateral thigh flap, and then reports three case studies which highlight the thigh flap as an excellent alternative for breast reconstruction in selected patients.

REFERENCES

  • 1 Handel N, Jenson J A, Black Q. et al . The fate of breast implants: a critical analysis of complications and outcomes.  Plast Reconstr Surg . 1995;  96 1521
  • 2 Kroll S S, Evans G RD, Reece G P. et al . Comparison of resource costs between implant-based and TRAM flap breast reconstruction.  Plast Reconstr Surg . 1996;  97 364
  • 3 Kroll S S. Why autologous tissue?.  Clin Plast Surg . 1998;  25 2
  • 4 Suominen S, Asko-Seljavaara S, von Smitten K. et al . Sequelae in the abdominal wall after pedicled or free TRAM flap surgery.  Ann Plast Surg . 1996;  36 629-636
  • 5 Koshima I, Soeda S. Inferior epigastric artery skin flap without rectus abdominis muscle.  Br J Plast Surg . 1989;  42 645-48
  • 6 Allen R J. The superior gluteal artery perforator flap.  Clin Plast Surg . 1998;  25 2
  • 7 Allen R J, Treece P. Deep inferior epigastric perforator flap for breast reconstruction.  Ann Plast Surg . 1994;  32 32
  • 8 Koshima I, Soeda S, Fukuda H. et al . The anterolateral thigh flap; variations in its vascular pedicle.  Br J Plast Surg . 1989;  42 260-262
  • 9 Kimata Y, Uchiyama K, Ebihara S. et al . Anatomic variations and technical problems of the anterolateral thigh flap: a report of 74 cases.  Plast Reconstr Surg . 1998;  102 1517-1523
  • 10 Baek S. Two new cutaneous free flaps: the medial and lateral thigh flaps.  Plast Reconstr Surg . 1983;  71 354-363
  • 11 Song Y G, Chen G, Song Y L. The free thigh flap: a new free flap concept based on the septocutaneous artery.  Br J Plast Surg . 1984;  37 149-159
  • 12 Ogawa T, Nakayama B, Hasegawa Y. et al . Treatment of malignant melanoma of the lower eyelid using anterolateral thigh flap.  Auris Nasus Larynx . 2000;  27 79-82
  • 13 Demirkan F, Chen H C, Wei F C. et al . The versatile anterolateral thigh flap: a musculocutaneous flap in disguise in head and neck reconstruction.  Br J Plast Surg . 2000;  53 30-36
  • 14 Kim H G, Ha B, Baek C H. et al . The short head of the biceps femoris as a monitor for the free lateral thigh flap in pharyngoesophageal reconstruction.  Br J Plast Surg . 2001;  54 62-66
  • 15 Kimata Y, Uchiyama K, Sekido M. et al . Anterolateral thigh flap for abdominal wall reconstruction.  Plast Reconstr Surg . 1999;  103 1191-1197
  • 16 Koshima I, Hosoda S, Inagawa K. et al . Free combined anterolateral thigh flap and vascularized fibula for wide, through-and-through oromandibular defects.  J Reconstr Microsurg . 1998;  14 529-534
  • 17 Luo S, Raffoul W, Luo J. et al . Anterolateral thigh flap: a review of 168 cases.  Microsurgery . 1999;  19 232-238
  • 18 Celik N, Wei F-C, Suominen S, Cheng M-H. Anterolateral thigh flap for postmastectomy breast reconstruction.  Sem in Plast Surg . 2002;  16 45-52
  • 19 Wei F C, Suominen S, Cheng M H. et al . Anterolateral thigh flap for postmastectomy breast reconstruction.  Plast Reconstr Surg . 2002;  110 82-88