Bilateral Internal Mammary Artery Perforator-pedicled Flaps for Anterior Chest Wall Keloid Resection: A Report of Two Cases of Lotus Petal Flaps in the Chest Wall

Complete resection of anterior chest wall keloids and direct closure of wound defects are difficult. Therefore, intrakeloid excision is usually the safest to treat anterior chest wall keloids. Total excision to relieve tension may require tensile suturing of the dermis or skin grafting, which can lead to recurrence or poor cosmetic outcomes. In this study, we performed total resection of the anterior chest wall keloid, followed by defect reconstruction using bilateral lotus petal flaps for the internal mammary artery perforators near the keloid, obtaining satisfactory results. When performing total keloid resection, releasing the precordial tension in the reconstruction area is crucial. The lotus petal flap, which can be elevated from the same precordial chest area, effectively releases tension and thus provides a beneficial treatment strategy.