Free adipomuscular diagonal upper gracilis flap as volume replacement for reconstruction of partial breast defect in the medial upper quadrant.

Introduction: The use of the gracilis flap has been extensively described for whole breast reconstruction, however its application as volume replacement for partial breast defects has only scarcely been described. This short communication covers two patient cases in which a free adipomuscular diagonal upper gracilis (DUG) flap is used as volume replacement for reconstruction of a partial breast defect in the medial upper quadrant of the breast following lumpectomy. Case introduction: Both patients are healthy middle-aged women who presented themselves with a breast malignancy in the upper medial quadrant of the left breast. Because of the tumor location, their small-to-moderate breast size and nonptotic breasts a free flap reconstruction was selected using a free diagnonal upper gracilis flap. Methods/Surgery technique: In both patients the flap was harvested conform current techniques. Results: Both flaps were successful with no evidence of (partial) flap loss. In one patient a wound dehiscence of the donor site was reported, which healed over time by secondary intention. Scar revision surgery was performed to improve the aesthetic appearance of the donor site. Both patients reported high satisfaction with their reconstructions, though the second patient has not yet underwent radiotherapy of the operated breast. Conclusion: The free adipomuscular gracilis flap represents a valuable option for volume replacement in partial breast reconstruction.