Arch Plast Surg.  2015 Nov;42(6):783-787. 10.5999/aps.2015.42.6.783.

"Mini-Flow-Through" Deep Inferior Epigastric Perforator Flap for Breast Reconstruction with Preservation of Both Internal Mammary and Deep Inferior Epigastric Vessels

• Satake T
• Sugawara J
• Yasumura K
• Mikami T
• Kobayashi
• Maegawa J

• KMID: 2152462
• DOI: http://doi.org/10.5999/aps.2015.42.6.783

Abstract

This procedure was developed for preservation of the rectus muscle components and deep inferior epigastric vessel after deep inferior epigastric perforator (DIEP) flap harvesting. A 53-year-old woman with granuloma caused by silicone injection underwent bilateral nipple-sparing mastectomies and immediate reconstruction with "mini-flow-through" DIEP flaps. The flaps were dissected based on the single largest perforator with a short segment of the lateral branch of the deep inferior epigastric vessel that was transected as a free flap for breast reconstruction. The short segments of the donor deep inferior epigastric vessel branch are primarily end-to-end anastomosed to each other. A short T-shaped pedicle mini-flow-through DIEP flap is interposed in the incised recipient's internal mammary vessels with two arterial and four concomitant venous anastomoses. Although it requires multiple vascular anastomoses and a short pedicle for the flap setting, the mini-flow-through DIEP flap provides a large pedicle caliber, enabling safer microsurgical anastomosis and well-vascularized tissue for creating a natural breast without consuming time or compromising the rectus muscle components and vascular flow of both the deep inferior epigastric and internal mammary vessels.

Keyword

Mammaplasty; Perforator flap; Microsurgery; Granuloma; Subcutaneous mastectomy

MeSH Terms

Breast*
Female
Free Tissue Flaps
Granuloma
Humans
Mammaplasty*
Mastectomy
Mastectomy, Subcutaneous
Microsurgery
Middle Aged
Perforator Flap*
Silicon
Silicones
Tissue Donors
Silicon
Silicones