Reversed Abdominoplasty in Aggressive Locally Advanced Breast Cancer Defect: A Safe Option for High Recurrence Risk Patients

The reverse abdominoplasty technique has uses that extend past cosmetic surgery into the field of reconstructive surgery. With a thorough understanding of the technique and modifications, this method may be used to cover extensive chest wall defects post-mastectomy in select patients. Reconstructive algorithms for locally advanced breast cancer tend to favor microsurgical techniques. However, the surgeon needs to choose the optimal reconstructive option based on the defect size, disease stage, future oncological therapeutic approach, and patients’ general condition. Patients with aggressive forms of breast cancer have higher risks of recurrence despite advances in chemotherapy. This subset of patients may be poor responders to adjuvant or neoadjuvant oncological drugs, may require postoperative radiotherapy, or be at high risk for early recurrence. In this subset of patients, we advocate the use of a reverse abdominoplasty for immediate autologous soft tissue coverage of the chest wall after breast cancer resection. It provides a robust soft tissue cover for radiotherapy and spares potential future autologous donor sites for delayed breast reconstruction while facilitating early clinical detection of recurrence. Here, we discuss a case treated with this technique and explore the surgical technique, pitfalls, and advantages of this technique with the outcome that validates decision-making.