Management of breast cancer —related lymphedema using free medial sural artery perforator (MSAP) flap: a VLVT approach

We describe the use of the free medial sural artery perforator (MSAP) flap in the management of breast cancer-related  lymphedema (BCRL). Patients with BCRL undergoing free MSAP flaps from 2020 to 2021 were identified. Patient characteristics, postoperative outcome, and quality of life were evaluated. Three patients underwent free MSAP flap. Average age and BMI were 41 years and 32.5 kg/m2, respectively. The three flaps survived completely. No donor site lymphedema was observed. No cellulitis infections developed. The three patients had a noticeable improvement in the diameter of the limb and reported a high satisfaction rate. The average diameter improvement was 13.8%. The average follow-up was 12  months. We believe the free MSAP flap can be used in the management of BCRL patients as a VLVT. The donor site is well hidden, and the risk of donor site lymphedema is nil. It restores lymphatic outflow of recipient sites. Level of evidence: Level IV, Therapeutic study
Source: European Journal of Plastic Surgery - Category: Cosmetic Surgery Source Type: research