title: [The free gracilis perforator flap for autologous breast reconstruction].
abstract: The free gracilis perforator flap is an alternative possibility for autologous breast reconstruction, if previous abdominal operations preclude this donor site, or if there is atypical distribution of fat tissue. The perforator flap is based on the main pedicle of the gracilis muscle. The muscle itself and its innervation can be completely preserved, if the angiosome of this vascular pedicle offers sufficient tissue. In skinny patients however it may be necessary to include the neighbouring angiosome of the second gracilis pedicle by means of the intramuscular anastomosis between both pedicles. In such a case a thin muscle strip with the joining vessel must be included in the flap. The bulk of the gracilis muscle and its motor nerve can, however, still be preserved. Breast reconstruction with this technique was successfully performed on six patients (two bilateral). It is a good alternative to a reconstruction with gluteal, or anteromedial, or lateral thigh perforator flaps.
authors.affiliation: Klinik für Plastische und Handchirurgie mit Brustzentrum; Behandlungszentrum Vogtareuth. Albutepeek@aol.com
authors.forename: A
authors.initials: A
authors.lastname: Peek
authors.forename: M
authors.initials: M
authors.lastname: Müller
authors.forename: K
authors.initials: K
authors.lastname: Exner
mesh_terms: D000328:Adult; D000368:Aged; D001158:Arteries / Q000601:surgery; D001943:Breast Neoplasms / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D012086:Reoperation; D013524:Surgical Flaps / Q000098:blood supply*; D020858:Tissue and Organ Harvesting / Q000379:methods