A New Technique of Breast Splitting: An Alternative Breast Reconstruction Technique Using a Pedicled Flap From the Contralateral Breast.

Breast reconstruction following mastectomy is a vital component of comprehensive cancer care, with a variety of techniques available to restore symmetry and form. This case report describes a 54-year-old woman who underwent a unique "breast-splitting" technique for right breast reconstruction after a mastectomy for a metaplastic carcinoma. The reconstruction was performed using a pedicled flap derived from the hypertrophic contralateral left breast, supplied not only by parasternal perforators, but also by several intercostal perforators from the breast septum, and was prepared with internal mammary vessels. The main advantages of this procedure over the previously described breast-splitting technique (based on the parasternal perforator) are the possibility to use a high-volume flap and to obtain a long pedicle, which allows free rotation of the flap and avoids the synmastia effect after passing under the skin of the sternum. At the same time, a Thorek breast reduction was performed on the left breast. The procedure yielded satisfactory aesthetic outcomes, and there were no complications at the 6-month follow-up. Further research is needed to assess the long-term outcome and wider applicability of this approach in breast reconstruction.