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

Purpose: 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.

Methods: 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.

Results: 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.

Conclusions: 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.