583 Use of LICAP Flap Reconstruction in a Breast Cancer Patient with Cosmetic Implants Undergoing Breast Conserving Surgery (2024)

Introduction

The Lateral Intercostal Artery Perforator (LICAP) flap has emerged as an alternative to implant-based or free tissue transplantation techniques in breast reconstructive surgery. This technique uses a pedicled flap to replace lost volume. This reconstructive method provides acceptable recovery times, lower rates of flap size morbidity, and better aesthetic satisfaction of patients compared to other methods.

In this study we describe a case of LICAP flap surgery in a patient with a previous history of aesthetic breast implants.

Case Presentation

A 49-year-old patient with bilateral aesthetic breast implants presented to the emergency department with a six-week history of an anterior neck lump. Radiological and histological investigations of this lesion revealed a primary carcinoma of the parotid gland with lymph node metastasis.

A staging whole-body scan for this lesion showed additional areas of increased uptake in the right axilla and breast. Dedicated radiological imaging demonstrated a 1.5 cm mass and multiple abnormal axillary lymph nodes. Biopsies confirmed a concurrent Grade 2 Intraductal Carcinoma of the right breast with metastatic axillary lymph node involvement.

A two-stage LICAP reconstructive approach was taken with no postoperative complications. The patient also underwent parotidectomy and neck dissection. Six months post-operatively, the patient remains well, having successfully navigated additional chemotherapy and hormonal suppressive therapy.

Conclusions

This case contributes to the evolving landscape of LICAP flap utility in BCS, emphasising its role as a low-risk and viable option. It underscores successful oncological management and the achievement of favourable aesthetic outcomes, including in complex scenarios with need for preservation of existing implants.