Open Access
CC BY 4.0 · Indian J Plast Surg 2025; 58(S 01): S5-S148
DOI: 10.1055/s-0045-1813607
Conference Abstracts

Double-Pedicle Unaffected Split-Breast Flap for Unilateral Breast Reconstruction

Classification of Study: Case Series

Autoren

  • Toshihiko Satake

    1   Faculty of Medicine, University of Toyama, Toyama, Japan

  • Maya Zuckerman

    1   Faculty of Medicine, University of Toyama, Toyama, Japan

  • Yufu Hosoi

    1   Faculty of Medicine, University of Toyama, Toyama, Japan

  • Chikano Amei

    1   Faculty of Medicine, University of Toyama, Toyama, Japan

  • Gaku Tachibana

    1   Faculty of Medicine, University of Toyama, Toyama, Japan

  • Satoshi Onoda

    1   Faculty of Medicine, University of Toyama, Toyama, Japan
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Correspondence: Toshihiko Satake (E-mail: toshi@med.u-toyama.ac.jp)

Abstract

Background In selected breast cancer patients with a contralateral hypertrophic and ptotic breast, autologous small-breast reconstruction combined with contralateral breast reduction is an effective option. This study evaluated the efficacy of the double-pedicle unaffected split-breast (USB) flap, harvested from the central half of the unaffected breast, for unilateral breast reconstruction with transverse scar reduction mammoplasty.

Methodology From February 2003 to May 2025, a total of 17 patients underwent reconstruction using the USB flap. The mean age was 59.1 years (range, 48–76), and the mean BMI was 24.2 kg/m2 (range, 19.5–33.3). The flap included half of the contralateral breast tissue, incorporating the 3rd or 4th internal mammary artery perforator (IMAP) and the lateral thoracic artery/vein (LTA/V). After flap elevation and LTA/V resection, perfusion from the IMAP was assessed using indocyanine green (ICG) angiography. The medial pedicle USB flap was rotated 180° and transferred via the midline. LTA/V was anastomosed to a recipient vessel to supercharge the distal flap portion. The remaining upper and lower poles of the contralateral breast were used for reduction mammoplasty.

Results Mean flap size was 13.3 × 26.9 cm (range, 9.5 × 22–16 × 29). All flaps and reduced breasts survived without major complications; one hematoma and one hypertrophic scar were noted. ICG showed poor perfusion in the distal lateral flap, comprising 22.0–48.5% of the flap area. Final aesthetic outcomes were rated “good” or “excellent” in 14 cases (82.4%) and “poor” or “fair” in 3 cases (17.6%). Mean follow-up was 53.8 months (range, 15–84), with no secondary primary breast cancer or recurrence in either breast.

Conclusion The USB flap with contralateral reduction mammoplasty offers a safe and aesthetically favorable option for breast cancer patients with a hypertrophic and ptotic contralateral breast.

Keywords: USB flap, double-pedicle breast flap, contralateral reduction, IMAP, LTA supercharging



Publikationsverlauf

Artikel online veröffentlicht:
10. November 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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