Anatomical study and new design of lateral intercostal artery perforator (LICAP) flap

Kazantsev I.B.; Korobeinikova V.I.

doi:https://doi.org/10.17116/plast.hirurgia202501124

Kazantsev I.B.

Tomsk Regional Clinical Hospital;
Siberian State Medical University

ORCID: 0000-0001-6955-2426

Korobeinikova V.I.

Tomsk Regional Clinical Hospital;
Siberian State Medical University

ORCID: 0000-0003-4432-0930

Anatomical study and new design of lateral intercostal artery perforator (LICAP) flap

Authors:

Kazantsev I.B., Korobeinikova V.I.

More about the authors

Journal: Plastic Surgery and Aesthetic Medicine. 2025;(1): 24‑31

DOI: 10.17116/plast.hirurgia202501124

Read: 1095 times

To cite this article:

Kazantsev IB, Korobeinikova VI. Anatomical study and new design of lateral intercostal artery perforator (LICAP) flap. Plastic Surgery and Aesthetic Medicine. 2025;(1):24‑31. (In Russ., In Engl.)
https://doi.org/10.17116/plast.hirurgia202501124

Подписка 2026 Пластическая хирургия и эстетическая медицина (Plastic Surgery and Aesthetic Medicine)

Использование инфографики авторами научных работ

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OBJECTIVE

To validate a new design of lateral intercostal artery perforator (LICAP) flap for closure of defects in the upper-lateral, lower-lateral and lower-medial quadrants of the breast.

MATERIAL AND METHODS

After anatomical dissection of cadaveric material, we studied anatomical bases of LICAP flap and formed a new LICAP flap design. Considering MRI data, we analyzed topography of perforator vessels of lateral intercostal artery and vein, their anatomical stability and constancy. Reconstructive surgeries using the developed flap design were introduced into practice with favorable functional and aesthetic results.

RESULTS

The LICAP flap has anatomically permanent vascular pedicle. The newly proposed flap design is able to close lateral breast defects with scar in inframammary fold.

Keywords:

perforator flaps

breast defects

LICAP flap

flap design

Authors:

Kazantsev I.B.

Tomsk Regional Clinical Hospital;
Siberian State Medical University

ORCID: 0000-0001-6955-2426

Korobeinikova V.I.

Tomsk Regional Clinical Hospital;
Siberian State Medical University

ORCID: 0000-0003-4432-0930

Received:

04.04.2024

Accepted:

12.08.2024

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References:

Koshima I, Soeda S. Inferior epigastric artery skin flaps without rectus abdominis muscle. Br J Plast Surg. 1989 Nov;42(6):645-648. PMID: 2605399. https://doi.org/10.1016/0007-1226(89)90075-1
Kim JT. Evolution and Revolution of Perforator Flaps. MEDICMEDICINE. 2017.
Kim JB, Kim DK, Lee JW, Choi KY, Chung HY, Cho DC, Park HY, Lee JY, Yang JD. The usefulness of pedicled perforator flap in partial breast reconstruction after breast conserving surgery in Korean women. Archives of Plastic Surgery. 2018;45(1):29-36. https://doi.org/10.5999/aps.2017.01200
Hou C, Chang S, Lin J, Song D. Surgical Atlas of Perforator Flaps. A Microsurgical Dissection Technique. Springer Dordrecht Heidelberg New York London: Springer Science Business+Media Dordrecht; 2015:224.
Taylor GI, Gianoutsos MP, Morris SF. The neurovascular territories of the skin and muscles:anatomic study and clinical implications. Plast Reconstr Surg. 1994;94:1. https://doi.org/10.1097/00006534-199407000-00001
Momoh AO, Colakoglu S, Westvik TS, Curtis MS, Yueh JH, de Blacam C, Tobias AM, Lee BT. Analysis of complications and patient satisfaction in pedicled transverse rectus abdominis myocutaneous and deep inferior epigastric perforator flap breast reconstruction. Annals of Plastic Surgery. 2012 July;69(1):19-23. PMID: 21659842. https://doi.org/10.1097/sap.0b013e318221b578
He WY, El Eter L, Yesantharao P, Hung B, Owens H, Persing S, Sacks JM. Complications and Patient-reported Outcomes after TRAM and DIEP Flaps: A Systematic Review and Meta-analysis. Plastic and Reconstructive Surgery — Global Open. 2020 Oct 29;8(10):e3120. PMID: 33173667; PMCID: PMC7647662. https://doi.org/10.1097/GOX.0000000000003120
Hamdi M, Van Landuyt K, de Frene B, Roche N, Blondeel P, Monstrey S. The versatility of the inter-costal artery perforator (ICAP) flaps. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2006;59(6):644-652. Epub 2006 Mar 22. PMID: 16716957. https://doi.org/10.1016/j.bjps.2006.01.006
Hamdi M, Van Landuyt K, Blondeel P, Hijjawi JB, Roche N, Monstrey S. Autologous breast augmentation with the lateral intercostal artery perforator flap in massive weight loss patients. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2009 Jan;62(1):65-70. Epub 2007 Nov 28. PMID: 18054303. https://doi.org/10.1016/j.bjps.2007.10.046
Carrasco-López C, Julian Ibañez JF, Vilà J, Luna Tomás MA, Navinés López J, Pascual Miguel I, Fernandez-Llamazares-Rodriguez J, Higueras-Suñe C. Anterior intercostal artery perforator flap in immediate breast reconstruction: Anatomical study and clinical application. Microsurgery. 2017 Sept;37(6):603-610. Epub 2017 Mar 28. PMID: 28370199. https://doi.org/https://doi.org/10.1002/micr.30171
Carrasco-López C, Julian Ibañez JF, Vilà J, Rodriguez-Baeza A, Carrera-Burgaya A, Reina-de-la-Torre F, Damaso-Margelí-Cervera V, Fernandez-Llamazares-Rodriguez J, Higueras-Suñe C. The Anterior Intercostal Artery Flap: Anatomical and Radiologic Study. Plast Reconstr Surg. 2017 Mar;139(3):613e-619e. PMID: 28234821. https://doi.org/10.1097/PRS.0000000000003058
Persichetti P, Tenna S, Brunetti B, Aveta A, Segreto F, Marangi GF. Anterior intercostal artery perforator flap autologous augmentation in bariatric mastopexy. Plast Reconstr Surg. 2012 Oct;130(4):917-925. PMID: 22691843. https://doi.org/10.1097/PRS.0b013e318262f38a
Iida T, Narushima M, Yoshimatsu H, Mihara M, Kikuchi K, Hara H, Yamamoto T, Araki J, Koshima I. Versatility of lateral cutaneous branches of intercostal vessels and nerves: anatomical study and clinical application. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2013 Nov;66(11):1564-1568. Epub 2013 July 26. PMID: 23896163. https://doi.org/10.1016/j.bjps.2013.06.056