INTERNAL MAMMARY VESSELS - A RELIABLE RECIPIENT SYSTEM FOR FREE FLAPSIN BREAST RECONSTRUCTION

In breast reconstruction with a free flap following mastectomy, the re cipient vessels most widely used are in the axillary system, which lim its flap movement and flexibility in breast shaping. In addition, scar ring and fibrosis can make dissection of the vessels difficult. We hav e performed 22 breast reconstructions using a free transverse rectus a bdominis myocutaneous (TRAM) flap anastomosed to the internal mammary (thoracic) vessels. There has been no flap failure. The surgical techn iques and the advantages and limitations of the internal mammary syste m are presented and the internal mammary vessels compared with the axi llary vessels as a recipient vascular system.