Association of pectoralis major myocutaneous flap and inverted T mammoplasty for reconstruction of extensive chest wall defect: case report

▪ ABSTRACT

Introduction:

In 1977, based on anatomical studies by McCraw et al., the pectoralis major muscle began to be used as an island myocutaneous flap. The present article describes a case of reconstruction of a defect in the anterior wall of the right hemithorax using the pectoralis major myocutaneous flap in an ipsilateral island.

Case Report:

AES, 66 years old, male, underwent wide resection of a recurrent infiltrative basal cell carcinoma measuring 13.0 x 8.0 cm in the right parasternal region. The myocutaneous flap was transposed through subcutaneous tunneling and the scars were positioned in the shape of an inverted T mammoplasty.

Conclusion:

This surgical tactic is easy to perform for surgeons accustomed to breast reconstruction, has a short surgical time, and has satisfactory aesthetic-functional results.

Keywords:

Skin neoplasms - Myocutaneous flap - Mammaplasty - Pectoralis muscles - Carcinoma, basal cell

Institution: Hospital Governador Celso Ramos, Florianópolis, SC, Brazil.

Publication History

Received: 23 October 2023

Accepted: 04 February 2024

Article published online:
20 May 2025

• REFERÊNCIAS

• 1 Pickrell KL, Baker HM, Collins JP. Reconstructive surgery of the chest wall. Surg Gynecol Obstet 1947; 84 (04) 465-476
• 2 McCraw JB, Dibbell DG, Carraway JH. Clinical definition of independent myocutaneous vascular territories. Plast Reconstr Surg 1977; 60 (03) 341-352
• 3 McCraw JB, Dibbell DG. Experimental definition of independent myocutaneous vascular territories. Plast Reconstr Surg 1977; 60 (02) 212-220
• 4 Freeman JL, Walker EP, Wilson JS, Shaw HJ. The vascular anatomy of the pectoralis major myocutaneous flap. Br J Plast Surg 1981; 34 (01) 3-10
• 5 Wei WI, Lam KH, Wong J. The true pectoralis major myocutaneous island flap: an anatomical study. Br J Plast Surg 1984; 37 (04) 568-573
• 6 Rauchenwald T, Dejaco D, Morandi EM, Djedovic G, Wolfram D, Riechelmann H. et al. The Pectoralis Major Island Flap: Short Scar Modified Muscle-Sparing Harvesting Technique Improves Aesthetic Outcome in Reconstructive Head and Neck Surgery. ORL J Otorhinolaryngol Relat Spec 2019; 81 (5-6): 327-337
• 7 de Fontaine S, Devos S, Goldschmidt D. Reduction mammaplasty combined with pectoralis major muscle flaps for median sternotomy wound closure. Brit J Plast Surg 1996; 49 (04) 220-222
• 8 Griffin P. Reduction mammaplasty combined with pectoralis major muscle flaps for median sternotomy wound closure. Brit J Plast Surg 1996; 49 (08) 575-576
• 9 Boodhun WS, Zinn R. Using a breast reduction to access a pedicled myocutaneous pectoralis major flap for anterior neck defect reconstruction: a case report. Australas J Plast Surg 2023; 6 (01) 71409
• 10 Schwarzmann E. Die technik der mammaplastik. Chirurg 1930; 2: 932-943
• 11 Pitanguy I. Une nouvelle technique de plastie mammaire. Étude de 245 cas consécutifs et présentation d’une technique personnelle. Ann Chir Plast (Marseille) 1962; 7 (03) 199-208
• 12 Duan W, Cao C, Wu J, Cen Y, Xu X, Liu Y. Application of modified inferior pedicle technique with inverted T pattern for severe breast hypertrophy. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2019; 33 (03) 341-344
• 13 Scomacao I, Cummins A, Roan E, Duraes EFR, Djohan R. The use of surgical site drains in breast reconstruction: A systematic review. J Plast Reconstr Aesthet Surg 2020; 73 (04) 651-662
• 14 Jo GY, Yoon JM, Ki SH. Reconstruction of a large chest wall defect using bilateral pectoralis major myocutaneous flaps and V-Y rotation advancement flaps: a case report. Arch Plast Surg 2022; 49 (01) 39-42