Perforator flap breast reconstruction has strong appeal for many women undergoing mastec‐ tomies, but the procedure requires adequate donor site tissue. The most common donor site for perforator flap breast reconstruction is the abdomen, such as the deep inferior epigastric perforator (DIEP) or superficial inferior epigastric artery (SIEA) flap, as most women have adequate donor site tissue, th...

BACKGROUND There continues to be controversy about performing abdominoplasty concurrently with abdominal liposuction. The concern is that liposuction on the already vascularly compromised abdominal flap will lead to increased complications and flap necrosis. The central abdomen is supplied by the epigastric system. If perforator vessels from this system are spared, the blood supply to the abdom...

Breast reconstruction using a perforator-based autologous flap is increasingly recognized as the preferred technique that provides an aesthetically pleasing restoration of breast form and volumewith longevity. Autologous flap reconstruction is widely accepted as the gold standard with deep inferior epigastric artery perforator (DIEP) flap being favored.1 When there is insufficient abdominal tis...

INTRODUCTION The free anterolateral thigh (ALT) skin perforator flap has gained enormous popularity as a free skin perforator flap. Currently being used for various reconstructions primarily in Asia, its routine application for soft-tissue reconstruction of the lower extremity remains unknown in the United States. The purpose of the present study was to review the current trend of flap selectio...

In 2009, 86,424 breast reconstructions were performed in the United States, with 76% being implant-based procedures. Capsular contracture and infection are the 2 most cited indications for implant explantation, resulting in a reconstruction failure. However, several patients are dissatisfied with implant reconstruction even without the aforementioned complications. We hypothesize that microvasc...

into a short “handle”. This was a full-thickness skin bridge at the pivot point where the proximal flap was rotated 180 degrees downward towards the recipient site. The bridge acted to offer cutaneous and subcutaneous continuity and maintained an intact subdermal plexus to serve as additional channel for venous drainage [2]. After the flap was transposed to the knee, a vein graft was utilised t...

The lower abdominal region is the most useful donor site for breast reconstruction. After Holmström and Robbins described the free transverse rectus abdominis myocutaneous flap, Koshima and Soeda transformed the flap into the deep inferior epigastric artery perforator (DIEP) flap.1–3 The DIEP flap has become popular for breast reconstruction throughout the world. However, free flap transfer req...

SUMMARY Reconstruction of soft-tissue defects on multiple fingers is challenging because the number of recipient vessels for free flaps is limited. We report the use of a free radial forearm flap with multiple perforator-based skin islands for the reconstruction of complex soft-tissue defects involving multiple fingers. The injuries were caused by a heat press. The flap was transferred, like "b...

A 65-year-old man presented with a hyperplastic anomalous anterior choroidal artery (AChA) associated with a ruptured internal carotid artery aneurysm at the origin of a perforating artery manifesting as sudden onset of headache and vomiting. The aneurysm was too small for endovascular embolization, so we performed open surgery via the left pterional approach. Aneurysm clipping with preservatio...