Tips for Successful Microvascular Abdominal Flap Breast Reconstruction Utilizing the “Total Rib Preservation” Technique for Internal Mammary Vessel Exposure

Abstract

The total rib preservation method of IMV exposure is a viable, reproducible, and reliable option for microvascular breast reconstruction. It does not increase warm ischemia, which suggests time taken for anastomosis is not affected by rib preservation. There is a learning curve and care has to be taken to avoid possible pitfalls. We recommend the use of a higher rib interspace than originally described because of the greater vessel calibre, superior vessel exposure, and therefore, easier anastomosis.