An extended superficial circumflex iliac artery perforator flap transfer for a relatively-small breast reconstruction after total mastectomy.

Superficial circumflex iliac artery (SCIA) perforator (SCIP) flap has been applied in various reconstructions. Unlike traditional groin flap, SCIP flap has a longer pedicle and can be used as a chimeric flap for complex reconstruction. By utilizing both the superficial and the deep branches of the SCIA, a SCIP flap can be raised as an extended large bulky flap. Although there are many articles reporting usefulness of SCIP flap, there is no case reporting a large SCIP flap transfer for breast reconstruction after total mastectomy. We applied a free extended SCIP flap for a case of post-total-mastectomy breast reconstruction. A 51-year-old female who had undergone total mastectomy and sentinel lymph node biopsy was referred for autologous tissue breast reconstruction. Physical exam revealed that the iliac and lower abdominal regions were suitable for a donor site. As the patient desired to preserve a similar donor site for possible future contralateral breast reconstruction, the iliac region was selected as a donor site. A 23 × 15 cm SCIP flap was elevated based on the superficial and the deep branches of the SCIA, and was transferred to the recipient site. The SCIA and concomitant vein were anastomosed to the lateral thoracic artery and vein in an end-to-end fashion. Postoperative course was uneventful. The reconstructed breast shape and texture were similar to the contralateral breast with no donor site complication, and the patient was very satisfied with functionally and esthetically pleasing results. Extended SCIP flap may be an option for relatively-small breast reconstruction.