Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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An Algorithmic Approach to Total Breast Reconstruction with Free Tissue Transfer

  • Yu, Seong Cheol (Department of Plastic and Reconstructive Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Kleiber, Grant M. (Section of Plastic Surgery, Department of Surgery, University of Chicago Medical Center, University of Chicago Pritzker School of Medicine) ;
  • Song, David H. (Section of Plastic Surgery, Department of Surgery, University of Chicago Medical Center, University of Chicago Pritzker School of Medicine)
  • Received : 2012.05.30
  • Accepted : 2012.06.28
  • Published : 2013.05.15
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Abstract

As microvascular techniques continue to improve, perforator flap free tissue transfer is now the gold standard for autologous breast reconstruction. Various options are available for breast reconstruction with autologous tissue. These include the free transverse rectus abdominis myocutaneous (TRAM) flap, deep inferior epigastric perforator flap, superficial inferior epigastric artery flap, superior gluteal artery perforator flap, and transverse/vertical upper gracilis flap. In addition, pedicled flaps can be very successful in the right hands and the right patient, such as the pedicled TRAM flap, latissimus dorsi flap, and thoracodorsal artery perforator. Each flap comes with its own advantages and disadvantages related to tissue properties and donor-site morbidity. Currently, the problem is how to determine the most appropriate flap for a particular patient among those potential candidates. Based on a thorough review of the literature and accumulated experiences in the author's institution, this article provides a logical approach to autologous breast reconstruction. The algorithms presented here can be helpful to customize breast reconstruction to individual patient needs.

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References

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