TL;DR: The vascular anatomy of the abdominal wall has been clinically studied in patients undergoing abdominal lipectomy and the anatomy, arc of rotation, and design alternatives of the rectus abdominis flap are shown.
Abstract: A rectus abdominis musculocutaneous island flap for breast reconstruction following mastectomy is presented. The vascular anatomy of the abdominal wall has been clinically studied in patients undergoing abdominal lipectomy. Cadaver dissections are shown, demonstrating the anatomy, arc of rotation, and design alternatives of the rectus abdominis flap. The surgical technique is demonstrated and representative patients are shown.
TL;DR: An inferior epigastric artery skin flap without rectus abdominis muscle, pedicled on the muscle perforators and the proximal inferior deep epigASTric artery, have been used in two patients.
TL;DR: This technique has all of the advantages of the free transverse rectus abdominis myocutaneous flap with decreased possibility of ventral hernia or muscle weakness.
Abstract: The ideal material for reconstruction of a breast is fat and skin. Most current methods of autogenous reconstruction use myocutaneous flaps. We investigated the feasibility of transfer of skin and fat from the lower abdomen without muscle sacrifice. The flap is based on one, two, or three perforators of the deep inferior epigastric vessels. The study will demonstrate both experimentally and clinically this original technique for breast reconstruction. Fifteen breasts have been successfully reconstructed with this technique. This technique has all of the advantages of the free transverse rectus abdominis myocutaneous flap with decreased possibility of ventral hernia or muscle weakness.
TL;DR: The data demonstrate that the free DIEP flap can limit the surgical damage to the rectus abdominis and oblique muscles to an absolute minimum and it is worthwhile to spend extra operative time, the main disadvantage of this technique, to limit late postoperative weakness of the lower abdominal wall.
TL;DR: The prospectively gathered data indicate that the free DIEP flap is a new but reliable and safe technique for autologous breast reconstruction and offers the patient the same advantages as the TRAM flap and discards the most important disadvantages of the myocutaneous flap.