INTERNAL MAMMARY VESSELS AS A RECIPIENT SITE

In breast reconstruction with a free flap, the selection of suitable r ecipient vessels remains one of the most critical decisions for the su rgeon. Most surgeons use one of the branches of the axillary vascular system, the thoracodorsal vessels. Because of a number of difficulties using this recipient site, the authors investigated the anatomy and a vailability of the internal mammary vessels for free flap breast recon struction. This article describes the anatomic considerations, surgica l technique, clinical experience, advantages, and limitations of using these vessels. In recent years, free autogenous tissue transfer for b reast reconstruction has become increasingly common. The free transver se rectus abdominis myocutaneous (TRAM) flap and the more recently des cribed deep inferior epigastric artery (DIEA) perforator flap are curr ently the methods of choice for postmastectomy breast reconstruction. For patients who cannot have a TRAM flap, free flaps from other donor sites (superior gluteal flap, inferior gluteal flap, Rubens flap, late ral transverse thigh flap) also have become important options.