Imperial College London

Mr Daniel Richard Leff

Faculty of MedicineDepartment of Surgery & Cancer

Reader in Breast Surgery



+44 (0)20 3312 1947d.leff




Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus






BibTex format

author = {Denning, M and Hayes, P and Tsang, F and Leff, D and Thiruchelvam, P and Hadjiminas, D},
doi = {10.1097/GOX.0000000000002785},
journal = {Plastic and Reconstructive Surgery Global Open},
title = {The modified crescenteric anterior intercostal perforator (AICAP) flap},
url = {},
volume = {8},
year = {2020}

RIS format (EndNote, RefMan)

AB - Background Lower pole breast cancers are challenging to manage since conventional wide local excision may produce a “bird beak” deformity. In an era of oncoplastic surgery, techniques that balance oncological results with cosmetic outcomes such as local flaps have extended the role of breast conserving surgery. Local flaps are particularly useful for partial breast reconstruction due to the relative simplicity of the surgical procedure, and reduced morbidity. Intercostal artery perforator (ICAP) flaps have a shorter duration of surgery than free flaps and do not require microsurgical anastomoses. AICAP flaps provide excellent cosmesis, yet traditional crescenteric harvest yields limited volume for reconstruction.Idea/InnovationWe describe a modification to an established reconstructive technique for lower pole breast defects. The technique is based on 3 extensions of tissue, providing a larger volume of tissue replacement compared with traditional AICAP flaps. The technique is particularly suitable for small and medium sized non-ptotic breasts, with lower pole tumours. ConclusionThe modified crescenteric AICAP technique can be used to increase the available tissue when performing lower pole reconstructions.
AU - Denning,M
AU - Hayes,P
AU - Tsang,F
AU - Leff,D
AU - Thiruchelvam,P
AU - Hadjiminas,D
DO - 10.1097/GOX.0000000000002785
PY - 2020///
SN - 2169-7574
TI - The modified crescenteric anterior intercostal perforator (AICAP) flap
T2 - Plastic and Reconstructive Surgery Global Open
UR -
UR -
VL - 8
ER -