Anterior Intercostal Artery Perforator Flap for Delayed Implant Exposure Salvage After Prepectoral Breast Reconstruction.

The anterior intercostal artery perforator (AICAP) flap has emerged as a viable option in breast reconstructive surgery for salvaging implants compromised by infection or radiotherapy. However, its application in delayed implant exposure following prepectoral reconstruction remains limited in the literature. The authors report the case of a 54-year-old woman who presented with localized infection and implant exposure following nipple-sparing mastectomy and prepectoral breast reconstruction with a silicone implant. Oncologic recurrence was excluded. Conventional conservative therapy failed, and the defect was successfully managed with an AICAP flap for implant salvage. This case highlights the feasibility of this technique as a less invasive alternative to avoid implant removal and secondary reconstruction, particularly in selected patients without extensive soft tissue compromise. Level of Evidence: 5 (Therapeutic).