The perforator flap from the contralateral large healthy breast as an alternative for breast reconstruction or combined breast and thoracic reconstruction.

[BACKGROUND] It has been demonstrated that contralateral breast tissue can be used for delayed breast reconstruction. The current report presented the clinical outcomes of the perforator flap from the contralateral lower breast as a pedicled flap for immediate or delayed breast reconstruction and as a free flap for delayed breast reconstruction or simultaneous breast and thoracic reconstruction in patients with macromastia.

[METHODS] From June 2014 to August 2018, a total of 15 female patients with a mastectomy defect on one side and a large healthy breast on the other side were collected in our department. The pedicled flap based on the fourth internal thoracic artery perforator from the healthy breast was harvested for three immediate breast reconstructions and five delayed breast reconstructions. The free flap with the thoracoacromial vascular pedicle from the contralateral breast was transferred to the defect side for three delayed breast reconstructions and four simultaneous breast and thoracic reconstructions.

[RESULTS] The flap sizes ranged from 9 × 26 to 20 × 40 cm. All flaps survived well postoperatively. Two patients developed delayed wound healing problems on the reconstructed breast. No patient had complications with reduction mammaplasty. The mean follow-up for patients was 21 months, with no tumor recurrence in either breast. The patients were satisfied with the reconstruction even though a certain degree of asymmetry was observed in all cases.

[CONCLUSION] For patients with a large healthy breast, the contralateral breast is an alternative tissue source for breast reconstruction or combined breast and thoracic reconstruction.