Breast Reconstruction With Profunda-artery Perforator Flap Combined With Fat Grafting After Mastectomy of Recurrent Phyllodes Tumor

A 36-year-old woman underwent resection of a borderline phyllodes tumor in the left breast in August 2016. It recurred twice and was again resected. In September 2021, it recurred for the third time. The patient underwent nipple-sparing mastectomy and immediate breast reconstruction with a profunda-artery perforator flap from the left thigh and grafted fat from the right thigh. The postoperative course was excellent. The phyllodes tumor did not recur. The patient was highly satisfied with the appearance of the breast and both thighs. The profunda-artery perforator flap is one of the safest and most commonly used methods in breast reconstruction. However, the flap volume can be limited, and its fat distribution is unequal. Combining it with fat grafting can supplement volume and contour, including in the upper breast area. This approach can be a useful option when a larger flap volume is needed.