Alternative autologous breast reconstruction using the free microvascular gracilis muscle flap with horizontal skin island

Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der Peripheren Nerven und Gefässe : Organ der Vereinigung der Deut
Steffen SchirmerHisham Fansa

Abstract

While free TRAM or DIEP flaps are still the most common techniques for autologous breast reconstruction, there are also other flaps which are suitable for patients who are not candidates for a TRAM/DIEP flap. In addition to the S-GAP or I-GAP, the transverse myocutaneous gracilis (TMG) flap is an excellent alternative. The tissue utilised is taken from the medial thigh and inferior gluteal area. PATIENTS AND OPERATIONS: We have performed 37 TMG flap operations on 23 patients since 2007. The indications were breast cancer, asymmetry of the breasts and capsular fibrosis. The average age of our patients was 47 years. Incisions are similar to those of a transverse thigh lift. The flap is nourished by perforators from the gracilis and its proximal dominant pedicle. The landmark ventrally is the greater saphenous vein and midpoint of the inferior gluteal fold on the dorsal side. Its size can go up to 30 x 10 cm. Recipient vessels are the internal thoracic vessels. The donor site is closed primarily. All of our patients are immobilised for 2 days and were instructed to avoid sitting for 2 weeks. 12 patients were reconstructed after breast cancer, 8 patients had a capsular fibrosis and 3 patients had an asymmetry. The follow-up period ...Continue Reading

Citations

Mar 3, 2011·Plastic and Reconstructive Surgery·Constance Neuhann-LorenzBruce L Cunningham

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