Source Surgery of The Breast Principals and Art Volume: n/a Number: n/a 1999

The Lateral Thigh Perforator Flap

This procedure harvests skin and fat from the "saddle bag" area of the lateral thigh. Based on tensor fascia lata musculocutaneous perforator vessels, the parent vessels are the lateral femoral circumflex artery and vein. Advantages of this technique over the tensor fascia lata myocutaneous flap include no muscle sacrifice and potentially less donor site contour deformity. Secondary liposuction for optimal lateral thigh contour has been necessary. Seroma of the do-nor site occurred in our two clinical cases (Fig. 21).

FIG. 21. A: A 52-year-old woman who had undergone left modified radical mastectomy and right prophylactic mastectomy presented with failed implant reconstruction. Despite six implant-related operations, the patient had painful capsular contracture and requested autogenous reconstruction, B: "Saddle bag" area chosen by patient for donor site for bilateral reconstruction. Note scant abdominal tissue and right paramedian scar. C: Donor skin island measured 19 x 6 cm. Perforators marked with Doppler. D: Intraoperative dissection of two perforators through the tensor fascia lata muscle to the lateral femoral circumflex vessels.

FIG. 21. Continued. E: Skin island with beveling to capture more fat with flap harvest. Flap weight was 327 g. F: Bilateral lateral. thigh perforator flap reconstruction at 3 1/2 years' follow-up. G: Post-operative donor site. H: Acceptable lateral thigh scar 3 1/2 years post-surgery.