Work

Lateral Intercostal Artery Perforator Flap for Axillary Breast Reconstruction in a Previously Irradiated and Dissected Field

Year: 2026

Type: article

Abstract: Reconstruction of axillary defects after oncologic resection is particularly challenging in patients with prior axillary dissection and radiation, as traditional thoracodorsal-based flaps may be unreliable. We present a case of a 59-year-old woman with recurrent left axillary invasive ductal carcinoma, 18 years after lumpectomy, axillary dissection, chemotherapy, and radiation. En bloc resection involving the pectoralis minor and serratus anterior created a 6 × 5 × 2 cm defect with exposed rib. A lateral intercostal artery perforator (LICAP) flap was used for reconstruction, based on a dominant perforator at the sixth intercostal space identified by Doppler and confirmed intraoperatively with indocyanine green angiography. The flap was de-epithelialized, tunneled to the axilla, and the donor site closed primarily. The patient achieved complete healing without necrosis or contracture and maintained full shoulder mobility after adjuvant chemoradiation. The LICAP flap offers a safe, reliable option for axillary reconstruction in previously treated fields.

Source: Indian Journal of Plastic Surgery

DOI: 10.1055/s-0046-1817012

Authors: Niki K. Patel, Joshua Henderson, Halil Safak Uygur

Institutions: West Virginia University, West Virginia University Hospitals

Language: English

Topic: Reconstructive Surgery and Microvascular Techniques

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7154455098