Mini‐breast reconstruction with an omental flap: a retrospective clinical study

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The recent trend favouring less invasive procedures in breast cancer surgery has led to skin‐sparing mastectomy and nipple‐areola‐sparing mastectomy being preferred to breast conservation surgery.1 Similarly, tumour‐specific immediate reconstruction is often used for accompanying simultaneous reconstruction.1 Immediate breast reconstruction can be performed effectively by using either prosthetic or autologous tissue. Pure autologous tissue reconstruction is preferable because of its reliability; natural ptotic results, including a soft and warm breast; absence of implant‐related complications and resistance to postoperative irradiation.2 Transverse rectus abdominis myocutaneous (TRAM) and latissimus dorsi (LD) flaps – pedicled or free – are the main flaps used in autologous breast reconstruction. The disadvantage of these autologous tissue reconstruction methods is possible donor‐site morbidity and deformity. Planning small breast reconstruction is difficult because of the limited choice in donor sites, thinner skin envelope and limited implant choices.5 Moreover, both prosthetic and autologous reconstruction may result in a breast mound larger than that of the contralateral breast when contralateral balancing surgery is declined by the patient.5 In such circumstances, the conventional options are a small LD myocutaneous flap and a small implant. However, the former can cause donor‐site morbidity such as large scars on the upper back and the LD muscle must be sacrificed, whereas the latter can lead to implant‐related complications and vulnerability to postoperative irradiation. To overcome these limitations, we present immediate postmastectomy reconstruction of small breasts with laparoscopically harvested pedicled omental flaps (LHPOFs) in five Korean women. To the best of our knowledge, this is the first Korean report of this nature.

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