Perforator Number Predicts Fat Necrosis in a Prospective Analysis of Breast Reconstruction with Free TRAM, DIEP, and SIEA Flaps

Abstract

The risk of fat necrosis in breasts reconstructed with free muscle-sparing TRAM, DIEP, and SIEA flaps increases as the number of perforators supplying the flap decreases. Breast reconstruction using DIEP and SIEA flaps may decrease abdominal donor-site morbidity compared with muscle-sparing TRAM flap techniques, but these flaps also carry a higher risk of fat necrosis that can compromise the breast reconstruction.