Rhomboid Flap Technique in Breast-conserving Surgery: An Alternative Method for the Reconstruction of Lumpectomy Defects

Limberg flap in mastectomy T-junction necrosis: an underutilised technique

The Wise-pattern skin-sparing mastectomy (SSM) is well known for its efficacy in large ptotic breasts, and its safety in facilitating immediate breast reconstruction. An unfortunate sequalae for all SSM techniques is mastectomy skin flap necrosis (MSFN) with a reported range of occurrence of 5%-30%. For the Wise pattern, the common area of wound dehiscence or necrosis is the T-junction. Different techniques have been described in the management of MSFN-ranging from primary closure to local and distant flaps. Full thickness MSFN results in wound breakdown and can expose a prosthesis, subsequently closure must be obtained with potential for the prosthesis to be explanted. To date, there has been no reports in the literature of the usage of a rhomboid flap in an SSM with immediate prepectoral implant. We discuss our experience in the usage of this local cosmetic flap to avoid prosthesis loss and have reviewed the literature regarding MSFN, the application of the rhomboid (Limberg) flap in breast surgery and its applicability in MSFN to preserve underlying prosthesis.

Limberg Flap in Breast Oncoplasty for Carcinoma Breast Revisited-a Tertiary Cancer Centre Experience

Limberg flap is currently not commonly used in breast oncoplasty. We present our experience with Limberg flap reconstruction in breast cancer patients who underwent breast conservation surgery. This study was conducted at a tertiary cancer centre in Kerala, India. We reviewed the records of patients with breast cancer who underwent Limberg flap reconstruction with breast conservation surgery from 1st January 2020 to 31st October 2021. Data collected included age, quadrant of tumour, side of tumour, T and N stage, status at surgery (primary or post neoadjuvant therapy), type of surgery, flap complications following surgery and breast deformity following surgery. Seventeen patients underwent Limberg flap reconstruction during the study period. The median age of the patients was 51 years. The commonest stage was cT1N0M0. Twelve patients underwent primary surgery and 5 post neoadjuvant chemotherapy. No patient had postoperative flap complications or breast deformity. Limberg flap is simple, versatile and robust and should be a part of the armamentarium of breast surgeons.