Autologous Reconstruction: Free Flaps

  • Hisham Fansa
  • Christoph Heitmann


DIEP- and ms-TRAM flaps are the workhorse free flaps in autologous breast reconstruction. The first TRAM flaps, transverse rectus abdominis muscle flaps, were cranially based on the rectus abdominis muscle and transposed to reconstruct the breast. Perfusion arises from the superior epigastric artery. The main disadvantage is that the lower abdomen is mainly perfused from the deep inferior epigastric artery and not the superior. The network between both of the arteries lies within the muscle and is very variable. It is not always sufficient to nourish the desired amount of tissue. Harvesting the muscle can result in weakness of herniation of the abdominal wall leading to pain or additional mesh stabilization surgery.


DIEP-Flaps, ms-TRAM Flaps and SIEA-Flaps

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Special Indications

    Lateral Thigh Flap

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    SGAP and IGAP Flaps

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Hisham Fansa
    • 1
    • 2
    • 3
  • Christoph Heitmann
    • 4
  1. 1.Department of Plastic, Reconstructive and Aesthetic SurgeryKlinikum BielefeldGermany
  2. 2.Center for Aesthetic Plastic Surgery and Reconstructive Breast SurgeryMunichGermany
  3. 3.Center for Aesthetic Plastic Surgery and Reconstructive Breast SurgeryZurichSwitzerland
  4. 4.Practice for Plastic SurgeryMunichGermany

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