Pectoralis Major Myocutaneous Flap in Females

Abstract

Background: Pectoralis major myocutaneous (PMMC) flap still finds a place in oral cancer reconstruction in certain settings such as salvage, free flap failure, and medically unfit patients. In females, raising a PMMC is considered challenging owing to its unreliability and donor site morbidity. We hereby report a literature review of the female PMMC and present our technique of the harvest to overcome these caveats. Patients and Methods: We followed our method of flap harvest in eight women. The lower neck flap and the upper chest flap are dissected and elevated in continuity. The skin paddle is placed completely in the infra-mammary crease, the dissection superior to the flap is done to raise the breast tissue off the PMMC, thus maintaining the integrity of breast tissue and incorporating the least amount of fat between the muscle and skin paddle. Results: The indications for the female PMMC were locally advanced primary in 2, surgical salvage in 2, free flap failure in 3, and medical comorbidity in 1 patient. Two patients had partial flap loss, one patient contracted a surgical site infection and another developed a seroma; all were managed conservatively. None had a complete flap loss. The mean duration of the hospital stay was 6 days. Conclusion: PMMC is still a viable reconstructive option in selected female patients. Our technique of flap harvest gives acceptable outcomes and retains the breast aesthetics.