Efficacy and Safety of the Minimal-Scarring Subdermal Adipo-Glandular Rotation Flap for Volume Displacement in Breast-Conserving Surgery: A Preliminary Comparative Study.

Abstract

The dermoglandular rotation flap with Burow's triangle is a widely used volume displacement technique in breast-conserving surgery (BCS) for breast cancer, particularly in cases with poor cosmetic prognoses. However, this method often results in extensive scarring. To address this limitation, we developed the subdermal adipo-glandular rotation flap (AGRF), designed to minimize surgical scars while preserving aesthetic outcomes. This study evaluates the efficacy and safety of AGRF. Between March 2022 and September 2023, 22 patients with breast cancer who underwent BCS with rotation flap reconstruction and sentinel lymph node biopsy were analyzed. Among them, 9 patients received AGRF (AGRF group), while 13 underwent the conventional dermoglandular rotation flap (control group). Surgical outcomes and complications were retrospectively compared. The AGRF group exhibited a significantly shorter median wound length compared to the control group (8.5 cm vs 18 cm, P < 0.001). Cosmetic outcomes were comparable between groups, with similar proportions of patients rated as excellent or good (AGRF vs control: Harvard scale, 100% vs 92%, P = 1.000; BCCT.core, 89% vs 85%, P = 1.000). No significant differences were observed in operative time, blood loss, postoperative pain, or fat necrosis. AGRF effectively reduces surgical scar length without compromising cosmetic outcomes or requiring complex techniques. This makes it a valuable option for volume displacement after BCS, particularly in patients with nonfatty breasts.