{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T10:01:57Z","timestamp":1753869717631,"version":"3.41.2"},"reference-count":18,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T00:00:00Z","timestamp":1731283200000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Thigh\u2010based free flaps are a common second\u2010line options in autologous breast reconstruction when the abdominal donor site is unavailable. While the profunda artery perforator (PAP) flap and gracilis\u2010based flaps are most commonly utilized in this scenario, certain anatomic variations may favor alternative flap selection. One such option is the medial circumflex femoral artery perforator flap (MCFLAP). This report describes a case of a 60\u2010year\u2010old patient with a history of abdominoplasty and left breast cancer who underwent skin sparing mastectomy, adjuvant radiation, and ultimately, unilateral autologous breast reconstruction using stacked MCFLAPs. While PAP flaps were initially considered, preoperative CT imaging revealed large septocutaneous perforators originating from the MCFA system, bilaterally. The flaps were designed and harvested on these perforators and weighed 335\u2009g on the right and 355\u2009g on the left. The internal mammary system was accessed at the level of the third rib, and the anterograde and retrograde artery and vein were used as recipient vessels. The patient did not experience any complications postoperatively. A revisionary and symmetrizing procedure was performed several months later, and at 18\u2009months, the patient had completely healed and reported satisfaction with the reconstruction. In addition to a detailed case description, the purpose of this report is to provide a review of the available literature on the MCFLAP including the anatomy, indications, and potential benefits and downfalls of this rare perforator flap. While the PAP flap is our preferred second\u2010line option for autologous breast reconstruction, it is important to be aware that in some instances the more suitable perforators may be arising from the MCFA system. In such cases, the MCFLAP should be considered.<\/jats:p>","DOI":"10.1002\/micr.31262","type":"journal-article","created":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T12:05:33Z","timestamp":1731326733000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Double Medial Circumflex Femoral Artery Perforator Flaps for Unilateral Breast Reconstruction\u2014A Case Report"],"prefix":"10.1002","volume":"44","author":[{"given":"Nicholas C.","family":"Oleck","sequence":"first","affiliation":[{"name":"Division of Plastic, Maxillofacial and Oral Surgery Duke University Medical Center  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miranda X.","family":"Morris","sequence":"additional","affiliation":[{"name":"Division of Plastic, Maxillofacial and Oral Surgery Duke University Medical Center  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Whitney O.","family":"Lane","sequence":"additional","affiliation":[{"name":"Division of Plastic, Maxillofacial and Oral Surgery Duke University Medical Center  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brett T.","family":"Phillips","sequence":"additional","affiliation":[{"name":"Division of Plastic, Maxillofacial and Oral Surgery Duke University Medical Center  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,11,11]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000003944"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002463"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534\u2010199506000\u201000015"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0007\u20101226(90)90071\u20107"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.SAP.0000067961.05231.11"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20102004\u2010820766"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20102006\u2010941719"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2013.07.003"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30670"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2005.01.026"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181b03a79"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000006681"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181956519"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20102002\u201036292"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100032\u20101313773"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100041\u20101726397"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12282\u2010016\u20100728\u2010x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000637\u2010199212000\u201000002"}],"container-title":["Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.31262","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T09:40:35Z","timestamp":1731922835000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/micr.31262"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11]]},"references-count":18,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1002\/micr.31262"],"URL":"https:\/\/doi.org\/10.1002\/micr.31262","archive":["Portico"],"relation":{},"ISSN":["0738-1085","1098-2752"],"issn-type":[{"type":"print","value":"0738-1085"},{"type":"electronic","value":"1098-2752"}],"subject":[],"published":{"date-parts":[[2024,11]]},"assertion":[{"value":"2024-07-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e31262"}}