Breast Cancer

, Volume 21, Issue 5, pp 635–640 | Cite as

Long-term results of breast volume replacement using an inframammary adipofascial flap after breast-conserving surgery

  • Tomoko OgawaEmail author
  • Noriko Hanamura
  • Masako Yamashita
  • Hiroko Kimura
  • Yumi Kashikura
Case Report


We have used an inframammary adipofascial flap for breast-conserving reconstruction in the inferior portion of the breast since 2005. The aim herein is to report this oncoplastic procedure in detail, including the long-term results. The surgical procedure was as follows: A skin incision is made at the inframammary line. After partial resection of the breast, a tongue-shaped flap of the fat and the anterior sheath of the rectus abdominis muscle are pulled up in the inframammary area. The flap is then inserted into the breast area where the tumor was removed, and it is secured with absorbable sutures to the surrounding breast tissue. When making the flap, it is very important to preserve several intercostal perforators around the inframammary line. Cosmetic results at more than 5 years after the operation in the 5 patients were assessed using photographs. The results were found to be good in 4 cases (80%) and poor in 1 case. The poor outcome was a case with 100% fat necrosis of the flap. This surgical procedure is easy to perform, and the long-term cosmetic outcomes were good, without complications. We consider this procedure to be useful for breast-conserving reconstruction after breast cancer occurring in the inferior portion of the breast.


Breast-conserving surgery Breast volume replacement Adipofascial flap 


  1. 1.
    Clough KB, Nos C, Salmon RJ, Soussaline M, Durand JC. Conservative treatment of breast cancers by mammaplasty and irradiation: a new approach to lower quadrant tumors. Plast Reconstr Surg. 1995;96:363–70.PubMedCrossRefGoogle Scholar
  2. 2.
    Nos C, Fitoussi A, Bourgeois D, Fourquet A, Salmon RJ, Clough KB. Conservative treatment of lower pole breast cancers by bilateral mammoplasty and radiotherapy. Eur J Surg Oncol. 1998;24:508–14.PubMedCrossRefGoogle Scholar
  3. 3.
    McCulley SJ, Macmillan RD. Planning and use of therapeutic mammoplasty—Nottingham approach. Br J Plast Surg. 2005;58:889–901.PubMedCrossRefGoogle Scholar
  4. 4.
    Kronowits SJ, Hunt KK, Kuerer HM, Strom EA, Buchholz TA, Ensor JE, et al. Practical guidelines for repair of partial mastectomy defects using the breast reduction technique in patients undergoing breast conservation therapy. Plast Reconstr Surg. 2007;120:1755–68.CrossRefGoogle Scholar
  5. 5.
    Clough KB, Kaufman GJ, Nos C, Buccimazza I, Sarfati IM. Improving breast cancer surgery: a classification and quadrant per quadrant atlas for oncoplastic surgery. Ann Surg Oncol. 2010;17:1375–91.PubMedCrossRefGoogle Scholar
  6. 6.
    Ogawa T, Hanamura N, Yamashita M, Ri Y, Kuriyama N, Isaji S. Usefulness of breast-volume replacement using an inframammary adipofascial flap after breast-conservation therapy. Am J Surg. 2007;193:514–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Sakai S, Suzuki I, Izawa H. Adipofascial (anterior rectus sheath) flaps for breast reconstruction. Ann Plast Surg. 1992;29:173–7.PubMedCrossRefGoogle Scholar
  8. 8.
    Harris JR, Levene MB, Svensson G, Hellman S. Analysis of cosmetic results following primary radiation therapy for stages I and II carcinoma of the breast. Int J Radiat Oncol Biol Phys. 1979;5:257–61.PubMedCrossRefGoogle Scholar
  9. 9.
    Al-Ghazal SK, Blamey RW, Stewart J, Morgan DAL. The cosmetic outcome in early breast cancer treated with breast conservation. Eur J Surg Oncol. 1999;25:566–70.PubMedCrossRefGoogle Scholar
  10. 10.
    Fujishiro S, Mitsumori M, Kokubo M, Nagata Y, Sasai K, Mise K, et al. Cosmetic results and complications after breast conserving therapy for early breast cancer. Breast Cancer. 2000;7:57–63.PubMedCrossRefGoogle Scholar
  11. 11.
    Vrieling C, Collette L, Fourquet A, Hoogenraad WJ, Horiot JC, Jager JJ, et al. The influence of patient, tumor and treatment factors on the cosmetic results after breast-conserving therapy in the EORTC ‘boost vs. no boost’ trial. Radiother Oncol. 2000;55:219–32.PubMedCrossRefGoogle Scholar
  12. 12.
    Noguchi M, Taniya T, Miyazaki I, Saito Y. Immediate transposition of a latissimus dorsi muscle for correcting a postquadrantectomy breast deformity in Japanese patients. Int Surg. 1990;75:166–70.PubMedGoogle Scholar
  13. 13.
    Noguchi M, Saito Y, Taniya T, Kitagawa H, Ohta N, Earashi M, et al. Wide resection with latissimus dorsi muscle transposition in breast conserving surgery. Surg Oncol. 1992;1:231–6.PubMedCrossRefGoogle Scholar

Copyright information

© The Japanese Breast Cancer Society 2011

Authors and Affiliations

  • Tomoko Ogawa
    • 1
    Email author
  • Noriko Hanamura
    • 1
  • Masako Yamashita
    • 1
  • Hiroko Kimura
    • 1
  • Yumi Kashikura
    • 1
  1. 1.Department of Breast SurgeryMie University Graduate School of MedicineTsuJapan

Personalised recommendations