Sensory Recovery of the Breast following Innervated and Noninnervated Lateral Thigh Perforator Flap Breast Reconstruction

BACKGROUND:The LTP flap, based on the tissue of the upper lateral thigh, is an excellent option for autologous breast reconstruction. The aim of this study was to introduce the technique to perform a nerve coaptation in LTP flap breast reconstruction and to analyze our results by comparing the sensory recovery of the reconstructed breast and donor site between innervated and noninnervated LTP flaps. METHODS:A prospective cohort study was conducted of patients who underwent an innervated or noninnervated LTP flap breast reconstruction between December 2014 and August 2018. Direct nerve coaptation was performed between a branch of the lateral femoral cutaneous nerve and the anterior cutaneous branch of the intercostal nerve. Sensory testing was done with Semmes-Weinstein monofilaments to assess the sensation of the native skin, flap skin and donor site during follow-up. RESULTS:In total, 24 patients with 37 innervated LTP flaps and 18 patients with 26 noninnervated LTP flaps were analyzed (median follow-up 17 and 15 months). Significantly lower mean monofilament values were found for the native skin (adjusted difference -0.83; p=0.011) and flap skin (adjusted difference -1.11; p