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Clinical Application of the Internal Mammary Artery Perforator Flap in Head and Neck Reconstruction

Yu, Benny T. M.D.; Hsieh, Ching-Hua M.D., Ph.D.; Feng, Guan-Ming M.D.; Jeng, Seng-Feng M.D.

Plastic and Reconstructive Surgery: April 2013 - Volume 131 - Issue 4 - p 520e–526e
doi: 10.1097/PRS.0b013e3182818c08
Reconstructive: Head and Neck: Original Articles

Background: The skin texture of the internal mammary artery perforator flap closely resembles that in the face and neck, making it the perfect source of tissue for head and neck reconstruction. In this article, the authors describe their experience in recent application of this flap in head and neck reconstruction and evaluate its pros and cons.

Methods: A total of 15 patients (three women and 12 men) with a mean age of 58.6 years received an internal mammary artery perforator flap for head and neck defect repair from April of 2007 to August of 2011. There were 11 internal mammary artery perforator pedicle flaps and four internal mammary artery perforator free flaps.

Results: Flap size ranged from 5 × 3 cm to 15 × 8 cm, pedicle length ranged from 3 to 6 cm, and 14 of 15 flaps (93.3 percent) had a sizable perforator identified during dissection. In the female patient who had no sizable perforator, the originally intended free flap was transformed to a platysma myocutaneous flap, which served as a backup procedure, extending from the same surgical incision. All of the transfers were successful. The donor sites were closed primarily in all patients except one, who received a split-thickness skin graft for a 15 × 8-cm donor defect.

Conclusion: With excellent skin color and tissue texture matching and minimal donor-site morbidity, the internal mammary artery perforator flap is emerging as a potential alternative reconstructive tool for the head and neck region.


Kaohsiung City, Taiwan

From the Department of Plastic and Reconstructive Surgery, E-Da Hospital, I-Shou University, and the Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University and College of Medicine.

Received for publication October 10, 2012; accepted November 1, 2012.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Seng-Feng Jeng, M.D.; Department of Plastic and Reconstructive Surgery, E-Da Hospital, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City 824, Taiwan,

©2013American Society of Plastic Surgeons