Pedicled transverse rectus abdominis musculocutaneous (TRAM) flaps have been generally
used for bilataral breast losses. The major disadvantages of this method are the total
or subtotal loss of the rectus abdominis muscles and various resulting postoperative
complications, such as abdominal bulging and lumbar pain. With the recent development
of perforator flaps and supermicrosurgery with anastomosis of 0.5-mm caliber vessels,
these serious complications can be overcome with a paraumbilical perforator adiposal
flap with only perforators without the deep inferior epigastric artery and the rectus
abdominis muscle. This article describes the successful use of paraumbilical adiposal
flap for patients with breast loss and facial contour deformities without secondary
debulking for recontouring. The advantages of this method are one-stage augmentation
with minimal donor site morbidity resulting in minimum invasive surgery with minimum
incision.
Paraumbilical perforator flap - supermicrosurgery - pedicled rectus abdominis myocutaneous
flap - deep inferior epigastric perforator flap
