Using the Retrograde Internal Mammary System for Stacked Perforator Flap Breast Reconstruction: 71 Breast Reconstructions in 53 Consecutive Patients

Plastic and Reconstructive Surgery
Mark W StalderAlireza Sadeghi

Abstract

Abdominal tissue is the preferred donor source for autologous breast reconstruction, but in select patients with inadequate tissue, additional volume must be recruited to achieve optimal outcomes. Stacked flaps are an effective approach in these cases, but can be limited by the need for adequate recipient vessels. This article reports outcomes for the use of the retrograde internal mammary system for stacked flap breast reconstruction in a large number of consecutive patients. Fifty-three patients underwent stacked autologous tissue breast reconstruction with a total of 142 free flaps. Thirty patients underwent unilateral stacked deep inferior epigastric perforator (DIEP) flap reconstruction, five had unilateral stacked profunda artery perforator flap reconstruction, one had bilateral stacked DIEP/superior gluteal artery perforator flap reconstruction, and 17 underwent bilateral stacked DIEP/profunda artery perforator flap reconstruction. In all cases, the antegrade and retrograde internal mammary vessels were used for anastomoses. In situ manometry studies were also conducted comparing the retrograde internal mammary arteries in 10 patients to the corresponding systemic pressures. There were three total flap losses (97.9 perce...Continue Reading

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Citations

Feb 25, 2017·Plastic and Reconstructive Surgery·Nicholas HaddockSumeet S Teotia
Nov 24, 2016·Plastic and Reconstructive Surgery·Claudio AngrigianiFrances M Walocko
Aug 23, 2018·Journal of Surgical Oncology·Akhil K Seth, Robert J Allen
Sep 12, 2018·Plastic and Reconstructive Surgery·Jop BeugelsJoshua L Levine
Aug 2, 2018·Annals of Plastic Surgery·Miguel de la Parra Marquez, Ricardo Fernandez-Riera
Jun 28, 2016·Plastic and Reconstructive Surgery·Teresa M BuescherBrian T Andrews
Oct 27, 2016·Plastic and Reconstructive Surgery·Robert J AllenRobert J Allen
May 10, 2018·Frontiers in Surgery·Ido BadashKetan M Patel
May 23, 2020·Plastic and Reconstructive Surgery. Global Open·Nicholas Till HaddockSumeet Sorel Teotia
Jul 26, 2017·Plastic and Reconstructive Surgery. Global Open·Jeffrey H LeeEric G Halvorson
Aug 10, 2019·Plastic and Reconstructive Surgery·Joshua L LevineRobert J Allen
Oct 9, 2020·Journal of Reconstructive Microsurgery·Katherine D Reuter MuñozSantosh S Kale
Aug 23, 2020·Plastic and Reconstructive Surgery·Rene D LargoPeirong Yu
Nov 10, 2020·Plastic and Reconstructive Surgery·Nicholas T HaddockSumeet S Teotia
Dec 29, 2020·Plastic and Reconstructive Surgery·Edward I Chang
Feb 17, 2021·Journal of Reconstructive Microsurgery·Ara A SalibianVishal D Thanik
Aug 24, 2021·Journal of Reconstructive Microsurgery·Dries OpsomerFilip Stillaert

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