Reduction of the DIEP flap donor site morbidity through a minimally invasive pedicle harvest with jacob's ladder incisions.

Despite the decrease of donor-site morbidity through the introduction of the deep inferior epigastric artery perforator (DIEP) flap as successor of the free transverse rectus abdominis (TRAM) flap, abdominal complications still occur. The etiology of lower abdominal bulging following breast reconstruction with the DIEP flap is still under debate. Most studies estimate the incidence for a postoperative lower abdominal bulging to be between 0.7% and 5%. However, a higher number of undetected and unreported cases is not unusual.