Simultaneous pectoralis major myocutaneous flap combined with breast reduction for sternal defect coverage

Background: The pectoralis myocutaneous island flap is a well established technique for tissue reconstruction. In female patients with concomitant breast hypertrophy there may be a simultaneous indication for breast reduction mammoplasty. The inferior pole of the breast and the inframammary fold coincide with the skin island territory of myocutaneous flaps supplied by the thoracoacromial artery. Methods: A technique is described where this tissue is preserved as the flap skin island in combination with a superior pedicle reduction mammoplasty. The technique is illustrated with two exemplary cases. Results and conclusion: The technique is suitable in women with relative unilateral or absolute bilateral large breasts with a combined sternal defect and should be taken into consideration for respective cases. (C) 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. Ail rights reserved.