Immediate Breast Reconstruction with LICAP and AICAP Flaps: A Retrospective Evaluation of Surgical Outcomes and Patient Satisfaction

Background: Oncoplastic surgery combines oncological resection with esthetic breast reconstruction, offering significant advancements in breast cancer management. Local perforator flaps, such as lateral intercostal artery perforator (LICAP) and anterior intercostal artery perforator (AICAP) flaps, are promising options for small-to-medium breast reconstructions. These flaps preserve underlying muscle and nerve structures, minimizing donor-site morbidity and enhancing esthetic outcomes and patient satisfaction. This study evaluates the clinical outcomes of LICAP and AICAP flaps for immediate breast reconstruction following quadrantectomy. Methods: A retrospective study was conducted at ASST Santi Paolo e Carlo Hospital, Milan, from September 2023 to March 2024. Twenty-five female patients who underwent quadrantectomy and immediate breast reconstruction with LICAP or AICAP flaps were included. Outcomes assessed included oncological safety, reoperation rates, flap viability, and esthetic outcomes using the BREAST-Q scale at 1 and 3 months postoperatively. Results: All patients achieved negative margins with no reoperations for oncological reasons. Flap viability was 100%, with no complications. BREAST-Q scores showed significant improvements in breast symmetry, shape, and quality of life, alongside enhanced emotional well-being and reduced postoperative pain. Conclusions: LICAP and AICAP flaps are safe and effective for immediate breast reconstruction, offering excellent esthetic outcomes, minimal donor-site morbidity, and improved patient satisfaction.