Lateral deltopectoral flap: a new and extended flap.

Tissues of the pectoral area such as skin and pectoralis major muscle are used in safe and extended flaps for cervical and neck reconstructions. As blood supply is derived from medial vessels (internal mammary artery) or lateral (thoracodorsal and lateral thoracic arteries), 2 different flaps can be constructed: medial and lateral deltopectoral flaps. Medial deltopectoral flap was developed by Bakamjian as an axial-pattern skin flap, and its blood supply depends on perforating branches from the internal mammary artery. When either parasternal skin or pectoralis major muscle must be resected, this flap obviously cannot be used. In this article, a new lateral deltopectoral flap based on lateral pedicles (from axilla and lateral thoracic area) is described. The successful use of this lateral deltopectoral flap in an extended cervical and thoracic reconstruction after resection of a giant basal cell carcinoma demonstrates that it must be considered as an alternative technique.