Bi-Paddle Pectoralis Major Myo-Cutaneous Flap: A Step by Step Approach

Abstract

We present a case of reconstruction of a large full thickness cheek defect as a result of cancer ablative surgery. This defect was reconstructed primarily by bi-paddle pectoralis major myo-cutaneous (PMMC) flap. This technique is anatomically sound, technically easy with short learning curve and also reproducible. One has to be careful, not to place more than one third of the skin paddle outside the muscle. This method of reconstruction is an alternative where microvascular free tissue transfer is contraindicated due to medical comorbidity or is not feasible due to either lack of the expertise or infrastructure. It is extremely useful in salvage in cases, in cases of the failure of microvascular flap, in selected large full thickness oral cavity lesions. However, the limitations of this method include loss of nipple area and technical difficulty in females and obese patients.