Internal mammary artery perforator-based plug flap

Various oncoplastic techniques have emerged over the years to preserve breast cosmesis and symmetry without compromising the principles of tumor excision. One of the newer techniques for breast volume replacement to achieve symmetry and cosmesis is the use of fascio-cutaneous pedicled chest wall perforator flaps or local perforator flaps (CWPF). We present a case of reconstruction with internal mammary artery perforator (IMAP)-based plug flap to fill the infero-medial defect caused by a tumor close to skin, with visible retraction. A 52 years old woman, with an extensive palpable mass (3 cm) in the lower medial quadrant of the right breast, the tumor was close to skin, with visible retraction. The patient has small and round breasts, without ptosis. In this situation and when there is skin that needs to be removed, reconstruction can be done with a pedicle flap skin paddle; the IMAP flap is an ideal donor site in these cases. It is a safe flap with good vascularization and offers a great cosmetic result. •The IMAP flap is a good indication for patients with tumors close to the skin.•The IMAP flap is a good indication for patients with small breasts without ptosis.•Breast conserving therapy is equivalent to that of mastectomy in early-stage cancer.•The IMAP flap is very useful for tumors in the middle quadrants of the breast.•Oncoplastic involves a combination of anatomical knowledge and oncological principles.