Breast Reconstruction Using the Lateral Intercostal Artery Perforator (LICAP) Flap: A Single-Institution Experience

Background: Breast Conservation Surgery (BCS) has become the standard of care in the management of early-stage breast cancer, offering outcomes comparable to mastectomy when combined with radiotherapy. In cases with a high tumor-to-breast volume ratio, achieving oncologic safety while preserving cosmesis can be challenging. The Lateral Intercostal Artery Perforator (LICAP) flap is a reliable volume replacement technique in such settings. Objective: To evaluate the outcomes of partial breast reconstruction using the LICAP flap, focusing on operative details, postoperative complications and patient satisfaction. Methods: A retrospective review was conducted at Liaquat National Hospital and Medical College, Karachi, from March 2020 to December 2024. Thirty-three patients undergoing BCS with immediate LICAP flap reconstruction were included. Patient demographics, tumor characteristics, operative time, postoperative morbidities and aesthetic outcomes were recorded. Patient satisfaction was assessed using the SDC1 PROM (Patient-Reported Outcome Measure) scale. Results: The mean patient age was 45.8 years. Most tumors (36.4%) were in the upper outer quadrant. Twelve patients (36.4%) received neoadjuvant chemotherapy and 36.4% underwent axillary dissection. Mean tumor size was 4.6 ± 1.8 cm. The median operative time was 145 minutes. Postoperative complications occurred in 3 patients (9%), including wound dehiscence, hematoma and minor erythema. All patients reported high satisfaction scores with favorable cosmetic outcomes. Conclusion: The LICAP flap is a safe and effective technique for partial breast reconstruction, providing adequate volume replacement and excellent aesthetic outcomes with minimal donor site morbidity.