A Workhorse Flap for Covering Moderate-sized Defects after Breast-conserving Surgery: Supercharged Lateral Thoracodorsal Flap

Background: The lateral thoracodorsal (LTD) flap technique is a type of oncoplastic breast surgery that involves transposition of tissue from the lateral aspect of a partial mastectomy defect. It is a relatively simple procedure and shows lower donor morbidity and good aesthetic outcomes. Complications, such as fat necrosis and wound dehiscence due to poor circulation, may occur at the distal part of the flap. We used a supercharged LTD flap to reduce this problem. In this study, the outcomes of the LTD flap over 13 years were reviewed. Methods: We performed a retrospective study of 86 patients who underwent an LTD flap procedure between 2007 and 2019. We analyzed patient information using medical chart review and classified patients into groups according to lateral thoracic artery perforator supercharging. The incidence of complications, such as fat necrosis and wound dehiscence, was also analyzed. Results: The mean tumor weight was 83.67 g, and defects had a moderate size, as they represented 25.02% of the total breast volume. Fat necrosis was noted in 19.4% of cases in the group without lateral thoracic artery perforator supercharging and 4% of cases in the group with supercharging, with a significantly lower rate in the supercharged group. Conclusions: Our findings show that the LTD flap could be used to cover moderate-sized defects after breast-conserving surgery. Careful dissection to preserve the lateral thoracic artery perforator resulted in the reduction of complications, such as fat necrosis, and excellent aesthetic results.