Recently in breast reconstruction, free flaps have come into favor because of greater reliability in blood supply and less flap morbidity. Initially, recipient site vessels were utilized from the subscapular system, particularly the thoracodorsal vessels. Many problems have been encountered using these vessels, and as a result, the internal mammary vessels have gained popularity. Other reported recipient vessels include the serratus anterior branch, the subscapular, the second intercostal and the thoracoacromial. We report the use of the IMA perforator as an alternative for recipient vessels in selected cases of free TRAM flap reconstructions. Advantages include expeditious preparation of recipient vessels as well as good length of these vessels. The superficial location of these vessels avoids the necessity of extensive dissections or rib removal, which is needed for other recipient vessels. These vessels can be easily identified and preserved in immediate reconstructions during mastectomies with the cooperation of surgical oncologists. In delayed reconstructions, these vessels may not be present due to the previous mastectomy. Therefore, we propose that the IMA perforator is a viable option for recipient vessels in free flap breast reconstruction for selected cases, enabling an efficient reconstruction.