"Mini-Flow-Through" Deep Inferior Epigastric Perforator Flap for Breast Reconstruction with Preservation of Both Internal Mammary and Deep Inferior Epigastric Vessels.
10.5999/aps.2015.42.6.783
- Author:
Toshihiko SATAKE
1
;
Jun SUGAWARA
;
Kazunori YASUMURA
;
Taro MIKAMI
;
Shinji KOBAYASHI
;
Jiro MAEGAWA
Author Information
1. Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Japan. toshi@yokohama-cu.ac.jp
- Publication Type:Brief Communication
- Keywords:
Mammaplasty;
Perforator flap;
Microsurgery;
Granuloma;
Subcutaneous mastectomy
- MeSH:
Breast*;
Female;
Free Tissue Flaps;
Granuloma;
Humans;
Mammaplasty*;
Mastectomy;
Mastectomy, Subcutaneous;
Microsurgery;
Middle Aged;
Perforator Flap*;
Silicon;
Silicones;
Tissue Donors
- From:Archives of Plastic Surgery
2015;42(6):783-787
- CountryRepublic of Korea
- Language:English
-
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.
