title: Superficial inferior epigastric artery (SIEA) free flap using perforator vessels as a recipient site: clinical implications in autologous breast reconstruction.
abstract: BACKGROUND
  Breast reconstruction with autogenous tissue is a well-established technique, but there are some limitations related to donor-site morbidity. Among available techniques, the superficial inferior epigastric artery (SIEA) flap is the least invasive procedure because it does not require harvesting or incision of the rectus muscle or the abdominal fascia. Besides adequate flap choice, the proper selection of the recipient vessels is an important factor. Thus, the internal mammary perforator branches (IMPBs) have been an attractive option regarding recipient pedicle morbidity.
  
  
  METHODS
  The investigators reported the use of the free SIEA flap with the IMPBs as a recipient site to reconstruct radical mastectomy.
  
  
  RESULTS
  Five patients with invasive ductal carcinoma underwent modified radical mastectomy and reconstruction. The IMPBs were selected as the recipient site and a free SIEA flap was used. The donor defect was closed directly without synthetic mesh. Satisfactory breast shape was achieved, and no complications were observed.
  
  
  CONCLUSIONS
  For selected patients, the SIEA flap and IMPBs may constitute a new alternative for immediate breast reconstruction, because of the possibility of large tissue transfer with minimal donor and recipient area morbidity. The SIEA pedicle size and the quality of IMPB vessels should be carefully evaluated.
authors: Division of Plastic Surgery, Department of Radiology, University of São Paulo School of Medicine, São Paulo, Brazil. munhozalex@uol.com.br
authors: Alexandre Mendonça
authors: AM
authors: Munhoz
authors: Leandro
authors: L
authors: Pellarin
authors: Eduardo
authors: E
authors: Montag
authors: José Roberto
authors: JR
authors: Filassi
authors: Adriano
authors: A
authors: Tachibana
authors: Heloisa
authors: H
authors: Gebrim
authors: Rolf
authors: R
authors: Gemperli
authors: Marcus Castro
authors: MC
authors: Ferreira
mesh_terms: D000792:Angiography / Q000379:methods; D001943:Breast Neoplasms / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000601:surgery; D019074:Epigastric Arteries / Q000000981:diagnostic imaging / Q000637:transplantation*; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply*; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008323:Mammary Arteries / Q000601:surgery*; D008408:Mastectomy; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D060053:Transplant Donor Site / Q000601:surgery; D014182:Transplantation, Autologous