title: Clinical Applications of the Transverse Musculocutaneous Gracilis Flap for Secondary Breast Reconstruction after Simple Mastectomy.
abstract: BACKGROUND
  In secondary autologous breast reconstruction, the current standard is a flap derived from the lower abdomen or the back. If these donor sites are not available because of lack of tissue, prior operations, or simply the patient's desire to avoid these donor sites, the authors use the transverse musculocutaneous gracilis flap if feasible.
  
  
  METHODS
  The authors retrospectively evaluated only patients where secondary autologous breast reconstruction was performed with a transverse musculocutaneous gracilis flap because of the prior mentioned reasons. Indications, limitations, advantages, and technique are discussed by sharing the authors' experience in 23 patients using 26 transverse musculocutaneous gracilis flaps.
  
  
  RESULTS
  No flap loss could be observed in this series. In four patients, minimal lateral skin necrosis could easily be managed by débridement and primary wound closure. In 12 cases, subsequent lipofilling was performed for a better breast shape. On average, patient satisfaction was high.
  
  
  CONCLUSIONS
  Secondary reconstruction after simple mastectomy using the transverse musculocutaneous gracilis flap requires a little more experience than after skin-sparing mastectomy but, especially combined with later lipofilling, can lead to an optimally shaped breast in selected patients with substantial skin laxity and fat distribution at the inner thigh.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Salzburg, Austria From the Department of Plastic and Reconstructive Surgery, Hospital of the Barmherzigen Brüder, Teaching Hospital of the Medical University Salzburg.
authors.forename: Gottfried
authors.initials: G
authors.lastname: Wechselberger
authors.forename: Heike
authors.initials: H
authors.lastname: Traintinger
authors.forename: Lorenz
authors.initials: L
authors.lastname: Larcher
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Russe
authors.forename: Monika
authors.initials: M
authors.lastname: Edelbauer
authors.forename: Florian
authors.initials: F
authors.lastname: Ensat
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D015413:Mastectomy, Simple / Q000379:methods*; D008875:Middle Aged; D064827:Myocutaneous Flap / Q000098:blood supply / Q000637:transplantation*; D012189:Retrospective Studies; D018570:Risk Assessment; D013848:Thigh / Q000601:surgery; D016896:Treatment Outcome