Internal Mammary Usability as Recipient Vessels in DIEP Breast Reconstruction in the Setting of Previous Radiation

Autologous breast reconstruction has become the standard of care over the last several decades. The recipient vessel for these patients with microvascular reconstruction has classically been the thoracodorsal (TD) artery. This artery has a reliable anatomic location and is often easily dissected and preserved when exploring the axilla as part of the oncological procedure.1 Recent recommendations have supported the use of the Internal mammary (IM) vessels for free flap anastomosis. The IM vessel selection allows for better arterial inflow, medial breast mound placement, shorter pedicle length, and avoids axillary exploration with resulting scarring and lymphedema risk.