The free superficially-based low abdominal mini (SLAM) flap for oncoplastic breast reconstruction

Ara A Salibian, Mark A Swerdlow, Katelyn Kondra, Ketan M Patel et al.
The free superficially-based low abdominal mini (SLAM) flap for oncoplastic breast reconstruction

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Volume replacement in oncoplastic breast reconstruction most commonly utilizes pedicled flaps. In thin patients with small breasts, free tissue transfer may be better-suited to preserve breast size. Evidence on microvascular oncoplastic reconstruction is limited and has often required sacrifice of potential future donor sites. The free superficially-based low abdominal mini (SLAM) flap utilizes a narrow strip of lower abdominal tissue based on superficial perfusion of the abdominal wall that is anastomosed to chest wall perforators to preserve the ability to perform future abdominally-based autologous breast reconstruction.

Five patients underwent reconstruction with SLAM flaps for immediate oncoplastic reconstruction. Mean age was 49.8 and body mass index was 23.5. Tumor location was most commonly in the lower outer quadrant (40%). Average lumpectomy size was 30 grams. Two flaps were based on the superficial inferior epigastric artery and three on the superficial circumflex iliac artery.

Recipient vessels included internal mammary perforators (40%), serratus branch (20%), lateral thoracic vessel branch (20%) and lateral intercostal perforators (20%). All patients underwent radiation therapy without delay and maintained volume, symmetry and contour at an average of 11.7 months after surgery. There were no cases of flap loss, fat necrosis, or delayed wound healing. The free SLAM flap allows for immediate oncoplastic breast reconstruction in thin, small-breasted patients with limited regional tissue without sacrificing future potential donor sites for autologous breast reconstruction.

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