Modified abdominal advancement flap with or without the Ochikomanai method: Oncoplastic surgery using a simple volume replacement technique

PURPOSE: To evaluate the usefulness of modified abdominal advancement flap (modified AAF) with and without the Ochikomanai method for breast-conserving surgery (BCS) based on cosmetic results and patient satisfaction. METHODS: We conducted a retrospective cohort study focusing on the usefulness of the modified AAF, based on cosmetic results and patient satisfaction, in 88 patients (89 breasts) who underwent BCS using the modified AAF with or without the Ochikomanai method. A historical cohort of patients who underwent standard AAF was used for comparison. RESULTS: Ten patients (11%) had complications; however, no fat necrosis was observed, and all complications improved with conservative treatment. With regard to cosmetic results, 41 breasts (58%) were rated excellent, 26 (37%) were rated good, and only 4 ([6%]) were unacceptable, all of which were rated fair. Patients with medium- or larger-sized breasts and older patients who underwent BCS using the modified AAF had acceptable cosmetic results. More than 89% of the patients indicated that they were somewhat or very satisfied in all 8 categories, except for physical limitations in the immediate postoperative period. CONCLUSION: BCS using a modified AAF, with or without the Ochikomanai method, is a useful technique for many patients, including those who are older and those with relatively large breasts.