Nipple-sparing mastectomy and breast reconstruction with a deep inferior epigastric perforator flap using thoracodorsal recipient vessels and a low lateral incision

2018 ◽  
Vol 118 (4) ◽  
pp. 621-629 ◽  
Author(s):  
Olivia A. Ho ◽  
Yi-Ling Lin ◽  
Marco Pappalardo ◽  
Ming-Huei Cheng
Keyword(s):  
Breast Reconstruction ◽  
Perforator Flap ◽  
Lateral Incision ◽  
Deep Inferior Epigastric Perforator ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

scholarly journals Orienting the superficial inferior epigastric artery (SIEA) pedicle in a stacked SIEA-deep inferior epigastric perforator free flap configuration for unilateral tertiary breast reconstruction

2020 ◽  
Vol 47 (5) ◽  
pp. 473-482
Author(s):  
Ya-han Yu ◽  
Dina Ghorra ◽  
Christine Bojanic ◽  
Oti N. Aria ◽  
Louise MacLennan ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Free Flaps ◽  
Inferior Epigastric Artery ◽  
Skin Paddle ◽  
Epigastric Artery ◽  
Internal Mammary ◽  
Siea Flap ◽  
Deep Inferior Epigastric Perforator ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

Superficial inferior epigastric artery (SIEA) flaps represent a useful option in autologous breast reconstruction. However, the short-fixed pedicle can limit flap inset options. We present a challenging flap inset successfully addressed by de-epithelialization, turnover, and counterintuitive rotation. A 47-year-old woman underwent left tertiary breast reconstruction with stacked free flaps using right deep inferior epigastric perforator and left SIEA vessels. Antegrade and retrograde anastomoses to the internal mammary (IM) vessels were preferred; additionally, the thoracodorsal vessels were unavailable due to previous latissimus dorsi breast reconstruction. Optimal shaping required repositioning of the lateral ends of the flaps superiorly, which would position the ipsilateral SIEA hemi-flap pedicle lateral to and out of reach of the IM vessels. This problem was overcome by turning the SIEA flap on its long axis, allowing the pedicle to sit medially with the lateral end of the flap positioned superiorly. The de-epithelialized SIEA flap dermis was in direct contact with the chest wall, enabling its fixation. This method of flap inset provides a valuable solution for medializing the SIEA pedicle while maintaining an aesthetically satisfactory orientation. This technique could be used in ipsilateral SIEA flap breast reconstructions that do not require a skin paddle, as with stacked flaps or following nipple-sparing mastectomy.

Microsurgical Breast Reconstruction for Nipple-Sparing Mastectomy

2013 ◽  
Vol 131 (2) ◽  
pp. 139e-147e ◽  
Author(s):  
Neil Tanna ◽  
P. Niclas Broer ◽  
Katie E. Weichman ◽  
Michael Alperovich ◽  
Christina Y. Ahn ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing
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