1.
Tans
ini I
. Sop
ra il
mio
nuo
vo p
roce
sso
di a
mpu
tazi
one
della
m
amm
ella
. Gaz
etta
Med
ica
Italia
na 1
906;
57:1
41.
2.
Ran
dolp
h, L
. C.,
Bar
one,
J.,
Ang
elat
s, J
., et
al.
Pre
dict
ion
of
post
oper
ativ
e se
rom
a af
ter l
atis
sim
us d
orsi
bre
ast r
econ
stru
ctio
n.
Pla
st. R
econ
str.
Sur
g. 2
005;
116
: 128
7-90
. 3.
Spe
ar S
L, H
ess
CL.
A re
view
of t
he b
iom
echa
nica
l and
func
tiona
l ch
ange
s in
the
shou
lder
follo
win
g tra
nsfe
r of t
he la
tissi
mus
dor
si
mus
cles
. Pla
st R
econ
str S
urg.
200
5 Ju
n;11
5(7)
:207
0-3.
Mel
issa
Cro
sby
MD
A
ssis
tant
Pro
fess
or
Dep
artm
ent o
f Pla
stic
Sur
gery
M
D A
nder
son
Can
cer C
ente
r H
oust
on, T
exas
• – – –
• •
– – • • •
– – –
•
– –
Ski
n P
addl
e La
tissi
mus
Dor
si
Mus
cle
with
Ski
n P
addl
e
Latis
sim
us D
orsi
M
uscl
e w
ith Im
plan
t U
nder
neat
h
D. H
amm
ond
• • – –
• •
Def
ect
LD fl
ap d
esig
n
LD fl
ap
LD fl
ap in
set
–
**P
rese
rve
med
ial b
ranc
h of
th
orac
odor
sal n
erve
•
–
• • • B
ostw
ick
PR
S 1
980
perfo
rato
rs
• • •
Cou
rtesy
P. C
hevr
ay
Rev
erse
Lat
issi
mus
Dor
si M
uscl
e Fl
ap E
leva
ted
and
Inse
t Bef
ore
Ski
n G
raft
Pos
t Ope
rativ
e R
esul
t
• • •
Cou
rtesy
D. C
hang
• • •
–
Cou
rtesy
R. S
kora
cki
Cou
rtesy
R. S
kora
cki
perfo
rato
r
• • •
•
• •
• •
– –
•
• • • •
– – – – – – – – –
Maj
ority
of G
raci
lis c
utan
eous
vas
cula
rity
is p
oste
rior i
n th
igh
Bre
ast r
econ
stru
ctio
n w
ith T
UG
flap
s
The
Mus
cle-
Sp
arin
g
Free
TR
AM
Fla
p/D
IEP
Fla
p
Mic
hel S
aint
-Cyr
, MD
, FR
CS
(C)
Dep
artm
ent o
f Pla
stic
Sur
gery
UTS
W M
edic
al C
ente
r at
Dal
las
DIE
A Va
scul
arity
and
bra
nchi
ng p
atte
rn
Zone
s of
Per
fusi
on M
edia
l Per
fora
tor
– – –
Type
2
DIE
A
Med
ial b
ranc
h
Late
ral b
ranc
h
–
•
TRA
M v
s M
S-1
M p
< 0
.816
TRA
M v
s M
S-1
L p
< 0
.817
Pre
serv
atio
n of
med
ial s
egm
ent
Late
ral p
erfo
rato
rs
Pre
serv
atio
n of
lat &
med
seg
men
ts
Late
ral p
erfo
rato
rs
Pre
serv
atio
n of
late
ral s
egm
ent
Med
ial p
erfo
rato
rs
Pre
serv
atio
n of
lat &
med
seg
men
ts
Late
ral a
nd m
edia
l per
fora
tors
• • •
• • • •
• •
• • •
Med
ial b
ranc
h of
DIE
A
DIE
A
Late
ral b
ranc
h of
D
IEA
Rec
tus
Can
div
ide
med
ial
bran
ch o
f DIE
A to
in
crea
se p
edic
le le
ngth
9-11
cm
ped
icle
le
ngth
Mor
e fre
edom
for
inse
tting
and
mic
ro
Mar
k or
ient
atio
n of
pe
dicl
e to
pre
vent
tw
istin
g la
ter
• • •
De-
epith
eliz
e fla
p an
d ta
per p
rior t
o in
setti
ng
(imm
edia
te
reco
nstru
ctio
ns)
Fasc
ial s
parin
g te
chni
que
allo
ws
for p
rimar
y fa
scia
l cl
osur
e