ABSTRACT
Breast reconstructive options are numerous. Since the advent of free tissue transfer breast reconstruction employing multiple donor possibilities, many factors have played a role in the evolution of optimizing both microsurgical success as well as flap insetting and the ultimate esthetic result. None of these are more important than the choice in recipient vessels for the microsurgical anastomoses. After the surgeon and patient decide upon the best-suited donor tissue and vessels for that individual, consideration is given to selecting the optimal recipient vessels. In free tissue breast reconstruction, the subscapular system has most frequently been used with good success.[1]
[2]
[3] The internal mammary system has been selectively used by some surgeons when the subscapular vessels are unavailable or inadequate and by others in defined patient groups, such as those undergoing delayed reconstruction.[1]
[3]
[4] We propose that the internal mammary vessels offer several advantages over the subscapular system and are an excellent primary choice as recipients for free tissue breast reconstruction. Our success in a large, consecutive series of 912 free tissue transfer breast reconstructions supports this premise.
KEYWORD
Internal mammary vessels - transverse rectus abdominus myocutaneous flap - deep inferior epigastric perforator flap
