Modified Insetting Method for Breast Projection in Breast Reonstruction with Free TRAM Flap

Introduction:

There are many reports about free TRAM flap, which is the leading method of using autograft

 in breast reconstruction. It is hard to get a successful reconstruction when the size of the flap is small

due to inadequate abdominal fat, abdominal scar etc. So the authors of this article are willing

to report successful own methods with case report.

Methods:

In all cases, we used ipsilateral DIEA as pedicle and Internal mammary vessels were the

recipient vessels in all cases. After insetting the flap transversely, we designed the flap by molding

with suture technique to global shape without zone III, IV excision. After marking the territory of skin

which was excised by GS surgeon on the flap, we de-epithelialized the area out of the territory.

Results:

Using this method, we had a successful result in aesthetical breast reconstruction.

Especially, we had good results when the lesion was located in lower pole or when the skin was minimally

incised. There were no post-op complications such as flap necrosis.

Conclusions:

The introduction of our new method on flap insertion, an easy method of getting adequate volume

using small flap, will be a good method especially for Asians who have small size body.