@article{ABS9844,
author = {Ali Basha and Amit Agrawal},
title = {Pedicled perforator flaps for partial breast reconstruction: a narrative review},
journal = {Annals of Breast Surgery},
volume = {10},
number = {0},
year = {2026},
keywords = {},
abstract = {Background and Objective: Chest wall perforator flaps (CWPFs) have become a vital option for volume replacement in partial breast reconstruction. This technique has expanded the scope of breast conservation, allowing excision of larger tumours in smaller breasts while maintaining excellent oncological and aesthetic outcomes. This article aims to briefly review the available literature on CWPF reconstructions and outline best practices across the pre-operative, operative, and post-operative phases of reconstruction.Methods: A narrative review of literature on partial breast reconstruction with pedicled perforator flaps was conducted. English studies published before August 2025 in PubMed and Embase databases were searched using relevant keywords and findings were synthesised with the senior author’s published literature and clinical experience.Key Content and Findings: We present a practical approach to CWPF breast reconstructions. Starting with a guide to patient and procedure selection using elements of history and physical examination. We outline key technical steps for the most commonly used CWPFs, including perforator mapping, pre-operative marking, dissection, and inset of the thoracodorsal artery perforator (TDAP), lateral thoracic artery perforator (LTAP), anterior intercostal artery perforator (AICAP) and medial intercostal artery perforator (MICAP) flaps. Finally, we describe our preferred post-operative management pathway and discuss common complications with emphasis on prompt recognition and management of adverse events. Collectively, this guide provides a structured framework that promotes patient safety and maximises cosmetic outcomes.Conclusions: CWPFs are versatile surgical options for partial breast reconstruction. Appropriate selection, meticulous surgical technique, and structured post-operative care are critical to achieving favourable outcomes. Future prospective data and focused clinical training will refine understanding of these techniques and drive further innovations.},
issn = {2616-2776}, url = {https://abs.amegroups.org/article/view/9844}
}