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Recently, our understanding of the vascularity of mastectomy flaps has improved [1]. Nevertheless, mastectomy flap necrosis is a common complication after mastectomy and immediate reconstruction with a deep inferior epigastric perforator (DIEP) flap [2]. If necrosis of a mastectomy flap occurs, additional surgery is required. If the necrotic area is small, it can be treated with an advancement flap or conservative treatment, but if the necrotic area is large, a skin graft may be necessary because of the distortion of the breast. In such cases, we should consider the possibility of additional donor site morbidity. Patients who have undergone abdominal free flap breast reconstruction usually have dog-ear deformities on both sides of the abdominal scar. After the abdominal free flap breast reconstruction, the most common secondary procedure is dog-ear correction of both flanks [3]. We introduce a method for reconstructing post-mastectomy skin necrosis after nipple-sparing mastectomy (NSM) and DIEP flap reconstruction by selecting remaining skin from the dog-ear excision for the second operation as the donor site for a new fullthickness skin graft (FTSG). This method was successfully performed in 2 cases.

A New Skin Graft Donor Site Using the Abdominal Dog-Ear Deformity in Mastectomy Flap Necrosis