Download PDF
Semin Plast Surg 2003; 17(1): 039-048
DOI: 10.1055/s-2003-39855
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Recent Innovations in Microsurgical Breast Reconstruction

Michael Klebuc, Aldona Spiegel, Jeffrey Friedman
  • Division of Plastic and Reconstructive Surgery, Baylor College of Medicine, Houston, TX
Further Information

Publication History

Publication Date:
16 June 2003 (online)

    Permissions and Reprints

ABSTRACT

Microsurgical breast reconstruction continues to be a dynamic field. Recent developments include the emergence of perforator flaps (deep inferior epigastric artery perforator flap) and the renewed interest in the superficial inferior epigastric artery flap as a means of reducing donor site morbidity. Clinical data have begun to accumulate outlining patient selection criteria for the above techniques. The role of the internal mammary vessels for microvascular anastomosis and the prospects of neurotizing flaps to augment sensory recovery are examined within the body of this article.

KEYWORDS

Breast - reconstruction - perforator flap - microsurgery

REFERENCES

  • 1 Koshima I, Soeda S. Free thin paraumbilical perforator-based flaps.  Ann Plast Surg . 1992;  29 12-17
    CrossrefPubMedGoogle Scholar
  • 2 Safak T, Klebuc M, Mavili E. et al . A new design of the iliac crest microsurgical free flap without including the 'obligatory' muscle cuff.  Plast Reconstr Surg . 1997;  100 1703-1709
    CrossrefPubMedGoogle Scholar
  • 3 Allen R J, Treece P. Deep inferior epigastric perforator flap for breast reconstruction.  Ann Plast Surg . 1994;  32 32-38
    Google Scholar
  • 4 Kroll S. Fat necrosis in free transverse rectus abdominis myocutaneous and deep inferior epigastric perforator flaps.  Plast Reconstr Surg . 2000;  106 576-583
    CrossrefPubMedGoogle Scholar
  • 5 Allen R J, Tucker Jr C. Superior gluteal artery perforator free flap for breast reconstruction.  Plast Reconstr Surg . 1995;  95 1207-1212
    CrossrefPubMedGoogle Scholar
  • 6 Arnez Z M, Khan U, Pogorelec D. et al . Breast reconstruction using the free superficial inferior epigastric artery (SIEA) flap.  Br J Plast Surg . 1999;  52 276-279
    CrossrefPubMedGoogle Scholar
  • 7 Taylor G I, Daniel R K. The anatomy of several free flap donor sites.  Plast Reconstr Surg . 1975;  56 243-252
    CrossrefPubMedGoogle Scholar
  • 8 Serletti J M, Moran S L. Microvascular reconstruction of the breast.  Semin Surg Oncol . 2000;  19 264-271
    CrossrefPubMedGoogle Scholar
  • 9 Elliott L F, Hartrampf Jr R C. The Rubens flap. The deep circumfles iliac artery flap.  Clin Plast Surg . 1998;  25 283-291
    PubMedGoogle Scholar
  • 10 Kimura N. A microdissected thin tensor fascia latae perforator flap.  Plast Reconstr Surg . 2002;  109 69-77
    CrossrefPubMedGoogle Scholar
  • 11 Futter C M, Webster M H, Hagen S. et al . A retrospective comparison of abdominal muscle strength following breast reconstruction with a free TRAM or DIEP flap.  Br J Plast Surg . 2000;  53 578-583
    CrossrefPubMedGoogle Scholar
  • 12 Nahabedian M, Dooley W, Singh N, Manson P. Contour abnormalities of the abdomen after breast reconstruction with abdominal flaps: the role of muscle preservation.  Plast Reconstr Surg . 2002;  109 91-101
    CrossrefPubMedGoogle Scholar
  • 13 Hamdi M, Weiler-Mithoff E, Webster M. Deep inferior epigastric perforator flap in breast reconstruction: experience with the first 50 flaps.  Plast Reconstr Surg . 1999;  103 86-95
    CrossrefPubMedGoogle Scholar
  • 14 Blondeel P, Vanderstraeten G, Monstrey S. et al . The donor site morbidity of free DIEP flaps and free TRAM flaps for breast reconstruction.  Br J Plast Surg . 1997;  50 322-330
    Google Scholar
  • 15 Arnez Z M, Khan U, Pogorelec D. et al . Breast reconstruction using the free superficial inferior epigastric artery (SIEA) flap.  Br J Plast Surg . 1999;  52 276-279
    CrossrefPubMedGoogle Scholar
  • 16 Stern H S, Nahai F. The versatile superficial inferior epigastric artery free flap.  Br J Plast Surg . 1992;  45 270-274
    CrossrefPubMedGoogle Scholar
  • 17 Nahabedian M, Momen B, Galdino G, Manson P. Breast reconstruction with the free TRAM or DIEP flap: patient selection, choice of flap, and outcome.  Plast Reconstr Surg . 2002;  110 466-475
    CrossrefPubMedGoogle Scholar
  • 18 Blondeel P N. One hundred free DIEP flap breast reconstructions: a personal experience.  Br J Plast Surg . 1999;  52 104-111
    CrossrefPubMedGoogle Scholar
  • 19 Liew S, Hunt J, Pennington D. Sensory recovery following free TRAM flap breast reconstruction.  Br J Plast Surg . 1996;  49 210-213
    CrossrefPubMedGoogle Scholar
  • 20 Place M J, Song T, Hardesty R A. et al . Sensory reinnervation of autologous tissue TRAM flaps after breast reconstruction.  Ann Plast Surg . 1997;  38 19-22
    CrossrefPubMedGoogle Scholar
  • 21 Shaw W W, Orringer J S, Ko C Y. et al . The spontaneous return of sensibility in breasts reconstructed with autologous tissues.  Plast Reconstr Surg . 1997;  99 394-399
    CrossrefPubMedGoogle Scholar
  • 22 Slezak S, McGibbon B, Dellon A L. The sensational transverse rectus abdominis musculocutaneous (TRAM) flap: return of sensibility after TRAM breast reconstruction.  Ann Plast Surg . 1992;  28 210-217
    CrossrefPubMedGoogle Scholar
  • 23 Yano K, Matsuo K, Hosokawa K. Breast reconstruction by means of innervated rectus abdominis myocutaneous flap.  Plast Reconstr Surg . 1998;  102 1452-1460
    CrossrefPubMedGoogle Scholar
  • 24 Blondeel P N, Demuynck M, Mete D. et al . Sensroy nerve repair in perforator flaps for autologous breast reconstruction: senstational or senseless?.  Br J Plast Surg . 1999;  52 37-44
    CrossrefPubMedGoogle Scholar
  • 25 Yap L H, Whiten S C, Forster A. et al . The anatomical and neurophysiological basis of the sensate free TRAM and DIEP flaps.  Br J Plast Surg . 2002;  55 35-45
    CrossrefPubMedGoogle Scholar
  • 26 Blondeel P N, Beyens G, Verhaeghe R. et al . Doppler flowmetry in the planning of perforator flaps.  Br J Plast Surg . 1998;  51 202-209
    Google Scholar
  • 27 Wechselberger G, Schoeller T, Bauer T. et al . Venous superdrainage in deep inferior epigastric perforator flap breast reconstruction.  Plast Reconstr Surg . 2001;  108 162-166
    CrossrefPubMedGoogle Scholar
      >