Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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"Mini-Flow-Through" Deep Inferior Epigastric Perforator Flap for Breast Reconstruction with Preservation of Both Internal Mammary and Deep Inferior Epigastric Vessels

  • Satake, Toshihiko (Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center) ;
  • Sugawara, Jun (Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital) ;
  • Yasumura, Kazunori (Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center) ;
  • Mikami, Taro (Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital) ;
  • Kobayashi, Shinji (Department of Plastic and Reconstructive Surgery, Kanagawa Children's Medical Center) ;
  • Maegawa, Jiro (Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital)
  • Received : 2015.06.15
  • Accepted : 2015.09.14
  • Published : 2015.11.15
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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.

Keywords

References

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