Surgical management for large chest keloids with internal mammary artery perforator flap

Therapy for large symptomatic keloids is often plagued with complicated reconstruction manner and recurrence. this article reports a rare treatment combination for a chest keloid with internal mammary artery perforator flap reconstruction and radiation therapy. we excised the keloid and covered the defect with an internal mammary artery perforator flap. immediate electron-beam irradiation therapy was applied on the second postoperative day. there was no sign of recurrence over the follow-up period of 18 months. the combination of internal mammary artery perforator flap and immediate radiation therapy is useful when faced with chest keloids of similar magnitude and intractability. © 2016 by anais brasileiros de dermatologia.