The pectoralis major musculo-mammary transposition flap to close a radical mastectomy defect: the breast switch.

The latissimus dorsi myocutaneous flap is the most commonly used workhorse flap to provide soft tissue closure of large breast amputation defects. When the thoracodorsal vascular pedicle is resected during a mastectomy, local tissue from lateral, contralateral, and inferior regions must be used. In this case report, complete transposition of the contralateral breast based on the pectoralis major muscle and its dominant pedicle was performed to close a massive mastectomy defect up to the anterior axillary line. The donor site defect that resulted at the inferior region was closed with a reverse abdominoplasty flap. A V-Y advancement overlying the ipsilateral latissimus dorsi muscle was advanced to close the lateral defect up to the anterior axillary line, connecting it to the contralateral breast switch.