Mammoplasty-Driven Pectoralis Major Myocutaneous Flap for Oral Cavity Defect Reconstruction in Female Oral Cancer Patients: A Novel Technique Preserving Aesthetics at 2 Sites.

The pectoralis major myocutaneous (PMMC) flap remains a widely utilized reconstructive option for oral cavity cancers, especially where microvascular surgery may not be feasible. However, its application in female patients presents unique challenges, including higher risk of flap failure and significant donor site deformity, notably breast disfigurement. To address these issues, we developed the mammoplasty-driven PMMC (MD-PMMC) technique, which integrates principles of breast mammoplasty to preserve donor site aesthetics without compromising flap viability. This innovative method maintains breast mound and minimizes displacement of the nipple-areola complex, thus preserving overall breast cosmesis. Applied in a cohort of 51 female patients, the MD-PMMC technique resulted in only 1 case of total flap loss. More than 80% of patients reported satisfaction with breast contour, with no instances of breast mound flattening. MD-PMMC offers an effective, reproducible reconstructive solution that balances optimal recipient site outcomes with superior donor site aesthetics in female patients.