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DOI: 10.5999/aps.2012.39.1.3
Breast Reconstruction with Microvascular MS-TRAM and DIEP Flaps
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The free muscle-sparing transverse rectus abdominis myocutaneous (MS-TRAM) and deep inferior epigastric perforator (DIEP) flaps involve transferring skin and subcutaneous tissue from the lower abdominal area and have many features that make them well suited for breast reconstruction. The robust blood supply of the free flap reduces the risk of fat necrosis and also enables aggressive shaping of the flap for breast reconstruction to optimize the aesthetic outcome. In addition, the free MS-TRAM flap and DIEP flap require minimal donor-site sacrifice in most cases. With proper patient selection and safe surgical technique, the free MS-TRAM flap and DIEP flap can transfer the lower abdominal skin and subcutaneous tissue to provide an aesthetically pleasing breast reconstruction with minimal donor-site morbidity.
Publication History
Received: 30 October 2009
Accepted: 19 November 2011
Article published online:
01 May 2022
© 2012. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)
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References
- 1 Holmstrom H. The free abdominoplasty flap and its use in breast reconstruction: an experimental study and clinical case report. Scand J Plast Reconstr Surg 1979; 13: 423-427
- 2 Roehl KR, Baumann DP, Chevray PM. et al. Evaluation of outcomes in breast reconstructions combining lower abdominal free flaps and permanent implants. Plast Reconstr Surg 2010; 126: 349-357
- 3 Chang DW, Reece GP, Wang B. et al. Effect of smoking on complications in patients undergoing free TRAM flap breast reconstruction. Plast Reconstr Surg 2000; 105: 2374-2380
- 4 Chang DW, Wang B, Robb GL. et al. Effect of obesity on flap and donor-site complications in free transverse rectus abdominis myocutaneous flap breast reconstruction. Plast Reconstr Surg 2000; 105: 1640-1648
- 5 Kim JY, Chang DW, Temple C. et al. Free transverse rectus abdominis musculocutaneous flap breast reconstruction in patients with prior abdominal suction-assisted lipectomy. Plast Reconstr Surg 2004; 113: 28e-31e
- 6 Lipa JE, Youssef AA, Kuerer HM. et al. Breast reconstruction in older women: advantages of autogenous tissue. Plast Reconstr Surg 2003; 111: 1110-1121
- 7 Miller RB, Reece G, Kroll SS. et al. Microvascular breast reconstruction in the diabetic patient. Plast Reconstr Surg 2007; 119: 38-45
- 8 Heller L, Feledy JA, Chang DW. Strategies and options for free TRAM flap breast reconstruction in patients with midline abdominal scars. Plast Reconstr Surg 2005; 116: 753-759
- 9 Tran NV, Chang DW, Gupta A. et al. Comparison of immediate and delayed free TRAM flap breast reconstruction in patients receiving postmastectomy radiation therapy. Plast Reconstr Surg 2001; 108: 78-82
- 10 Chang DW, Barnea Y, Robb GL. Effects of an autologous flap combined with an implant for breast reconstruction: an evaluation of 1000 consecutive reconstructions of previously irradiated breasts. Plast Reconstr Surg 2008; 122: 356-362
- 11 Chang DW, Kim S. Breast reconstruction and lymphedema. Plast Reconstr Surg 2010; 125: 19-23
- 12 Saint-Cyr M, Youssef A, Bae HW. et al. Changing trends in recipient vessel selection for microvascular autologous breast reconstruction: an analysis of 1483 consecutive cases. Plast Reconstr Surg 2007; 119: 1993-2000
- 13 Saint-Cyr M, Chang DW, Robb GL. et al. Internal mammary perforator recipient vessels for breast reconstruction using free TRAM, DIEP, and SIEA flaps. Plast Reconstr Surg 2007; 120: 1769-1773
- 14 Sacks JM, Chang DW. Rib-sparing internal mammary vessel harvest for microvascular breast reconstruction in 100 consecutive cases. Plast Reconstr Surg 2009; 123: 1403-1407
- 15 Bajaj AK, Chevray PM, Chang DW. Comparison of donorsite complications and functional outcomes in free musclesparing TRAM flap and free DIEP flap breast reconstruction. Plast Reconstr Surg 2006; 117: 737-746
- 16 Wu LC, Bajaj A, Chang DW. et al. Comparison of donorsite morbidity of SIEA, DIEP, and muscle-sparing TRAM flaps for breast reconstruction. Plast Reconstr Surg 2008; 122: 702-709