J Reconstr Microsurg 2011; 27(7): 427-432
DOI: 10.1055/s-0031-1281527
© Thieme Medical Publishers

Breast Reconstruction Using the Lateral Femoral Circumflex Artery Perforator Flap

Gabriel M. Kind1 , 2 , Robert D. Foster2
  • 1Department of Plastic Surgery, California-Pacific Medical Center, San Francisco, California
  • 2Division of Plastic Surgery, Department of Surgery, University of California – San Francisco, San Francisco, California
Further Information

Publication History

Publication Date:
15 July 2011 (online)

ABSTRACT

The development of microsurgical breast reconstruction has resulted in not only the lower abdomen as a source of donor site tissue but also interest in alternative donor sites. These have included perforator-based flaps at the sites of previously described myocutaneous flaps (e.g., superior or inferior gluteal arteries) and the use of myocutaneous flaps not previously used for breast reconstruction (e.g., gracilis or transverse upper gracilis). We present our experience with a unique form of the tensor fascia lata flap and describe the first reported use of the lateral femoral circumflex artery (LFCA) perforator flap for breast reconstruction. A patient with minimal abdominal fat but lipodystrophy of the upper lateral thighs presented for breast reconstruction. Perforator flaps based on the lateral femoral circumflex vessels were designed. The LFCA perforator flap from one side was successfully used for breast reconstruction. The flap on the contralateral side did not have a suitable perforator. The LFCA perforator flap offers another option for women seeking autogenous breast reconstruction. Advances in preoperative imaging will likely make this a more reliable option.

REFERENCES

  • 1 Hill H L, Nahai F, Vasconez L O. The tensor fascia lata myocutaneous free flap.  Plast Reconstr Surg. 1978;  61 (4) 517-522
  • 2 Nahai F, Silverton J S, Hill H L, Vasconez L O. The tensor fascia lata musculocutaneous flap.  Ann Plast Surg. 1978;  1 (4) 372-379
  • 3 Mathes S J, Buchanan R T. Tensor fascia lata: neurosensory musculo-cutaneous free flap.  Br J Plast Surg. 1979;  32 (3) 184-187
  • 4 Deiler S, Pfadenhauer A, Widmann J, Stützle H, Kanz K G, Stock W. Tensor fasciae latae perforator flap for reconstruction of composite Achilles tendon defects with skin and vascularized fascia.  Plast Reconstr Surg. 2000;  106 (2) 342-349
  • 5 Koshima I, Urushibara K, Inagawa K, Moriguchi T. Free tensor fasciae latae perforator flap for the reconstruction of defects in the extremities.  Plast Reconstr Surg. 2001;  107 (7) 1759-1765
  • 6 Kimura N. A microdissected thin tensor fasciae latae perforator flap.  Plast Reconstr Surg. 2002;  109 (1) 69-77, discussion 78–80
  • 7 Shaw W W. Breast reconstruction by superior gluteal microvascular free flaps without silicone implants.  Plast Reconstr Surg. 1983;  72 (4) 490-501
  • 8 Allen R J, Tucker Jr C. Superior gluteal artery perforator free flap for breast reconstruction.  Plast Reconstr Surg. 1995;  95 (7) 1207-1212
  • 9 Boustred A M, Nahai F. Inferior gluteal free flap breast reconstruction.  Clin Plast Surg. 1998;  25 (2) 275-282
  • 10 Wechselberger G, Schoeller T. The transverse myocutaneous gracilis free flap: a valuable tissue source in autologous breast reconstruction.  Plast Reconstr Surg. 2004;  114 (1) 69-73
  • 11 Kind G M, Foster R D. The longitudinal gracilis myocutaneous flap: broadening options in breast reconstruction.  Ann Plast Surg. 2008;  61 (5) 513-520
  • 12 Masia J, Kosutic D, Cervelli D, Clavero J A, Monill J M, Pons G. In search of the ideal method in perforator mapping: noncontrast magnetic resonance imaging.  J Reconstr Microsurg. 2010;  26 (1) 29-35
  • 13 Scott J R, Liu D, Said H, Neligan P C, Mathes D W. Computed tomographic angiography in planning abdomen-based microsurgical breast reconstruction: a comparison with color duplex ultrasound.  Plast Reconstr Surg. 2010;  125 (2) 446-453
  • 14 Rozen W M, Anavekar N S, Ashton M W et al.. Does the preoperative imaging of perforators with CT angiography improve operative outcomes in breast reconstruction?.  Microsurgery. 2008;  28 (7) 516-523
  • 15 Hubmer M G, Schwaiger N, Windisch G et al.. The vascular anatomy of the tensor fasciae latae perforator flap.  Plast Reconstr Surg. 2009;  124 (1) 181-189
  • 16 Vasile J V, Newman T, Rusch D G et al.. Anatomic imaging of gluteal perforator flaps without ionizing radiation: seeing is believing with magnetic resonance angiography.  J Reconstr Microsurg. 2010;  26 (1) 45-57

Gabriel M KindM.D. F.A.C.S. 

45 Castro Street

Suite 410, San Francisco, CA 94114

Email: gkind@yahoo.com