The evaluation of tissue sufficiency regarding the transverse myocutaneous gracilis flap for breast reconstruction in thin individuals

Abstract

Objective: For autologous breast reconstruction, the flaps of choice are mainly centered around abdominal tissue as the primary donor site. Yet with the increase in newly diagnosed young, nulliparous breast cancer patients, the abdomen may sometimes not be a suitable option as donor tissue. The transverse myocutaneous gracilis (TMG) flap has become a popular alternative for breast reconstruction candidates in this patient group. The purpose of this study was to evaluate the tissue sufficiency of the medial thigh regarding breast reconstruction in thin individuals. Material and Methods: The study was conducted on 116 female volunteers with a slim body habitus. The age, height, weight, history of pregnancy and breast cup sizes were questioned for each patient and body mass indexes (BMI) were calculated. A skinfold caliper was used to objectively evaluate the tissue thickness of the proximal medial thigh and the lower abdomen. Participants were categorized into three groups according to their breast cup size and the relationship between breast size, BMI, and thigh pinch thickness were evaluated. Results: The mean age was 24.7 years and the mean BMI was 20.63. Statistical analysis revealed a significant relationship between the breast cup size and BMI values (p< 0.05). This correlation was also evident for the relationship between the breast cup size and the medial thigh pinch thickness. A similar relationship was not evident regarding the lower abdominal pinch values and breast cup size. Conclusion: The decision regarding the donor site and tissue sufficiency is undertaken by the surgeon in a mainly subjective manner. This study demonstrates that thin, nulliparous patients with abdominal areas that are unfit as donor sites can provide a higher thickness of tissue from the medial thigh region, especially for the reconstruction of small to medium sized breasts.