Chest Wall Perforator Flap
Suited for small to large breasted patients, the chest wall perforator flap involves using the dermis (inner layer of skin) and fat from under the arm along the lateral chest wall. After the cancer is removed, this section of tissue is lifted off the body but kept on its blood supply vessels (perforators), and rotated into the cavity left behind by the cancer.
This form of reconstruction is suited for cases of cancer ranging in size from 20% to 40% of the entire breast. Consequently, when combined with breast conserving surgery, the chest wall perforator flap may serve as a viable alternative to some cases of mastectomy with reconstruction.
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Illustration of the dermis and fat under the arm being rotated into the breast cavity
The key advantage to this reconstruction alternative is that the patient with a sizable cancer is able to avoid a mastectomy and can keep her breasts. A disadvantage will be the scar under the armpit that is unavoidable, however these scars tend to fade over time and in most cases are concealed by the bra.