Purpose: Breast related trauma may result from blunt force, penetrating injuries or burns (1). Breast reconstruction in the setting of blunt trauma can pose challenges with asymmetry and scar contracture providing additional obstacles. There is a paucity of published articles relating to use of oncoplastic surgery techniques to rectify trauma-related breast injuries exists, likely reflecting the rarity of this presentation. While some authors have attempted to classify and give descriptions of breast haematomas and their management, little attention has been given to correction of the deformities left by parenchymal devascularisation and resulting parenchymal necrosis (2). Methods: This paper presents a series of unique instances of severe breast deformity and nipple retraction caused by a seatbelt injury, leading to a cleft deformity and fat necrosis. Results: Traditional approaches like reduction mammoplasty were deemed to be unsuitable, prompting the use of an advanced oncoplastic technique—a reverse lateral intercostal artery perforator (LICAP) flap—for reconstruction and symmetry. Conclusions: This report aims to address a gap in trauma-related breast reconstruction by describing an innovative volume replacement strategy for complex cases involving blunt-force injuries. 1. Vazquez Perez A, Deville P, Hargis M, Hunt JP, Marr AB, Stuke LE, Schoen JE, Greiffenstein PP, Smith AA. Traumatic Breast Injuries in High-Risk Communities. Am Surg. 2023 Dec;89(12):6351-6352. doi: 10.1177/00031348231174020. Epub 2023 May 11. PMID: 37166837. 2. Yoon J, Ponce CB, Contractor S. Blunt breast trauma treated with endovascular embolization. J Vasc Interv Radiol. 2014 Jun;25(6):981-3. doi: 10.1016/j.jvir.2014.02.003. PMID: 24857948.