The authors wish to thank Dr. D'Arpa for his letter and congratulate his team on their excellent results. One of the best things about our field is that there are often numerous ways to achieve the same end result. The technique we demonstrate works well in our hands. We have not had complications with bleeding of the muscle edge or other issues outlined by Dr. D'Arpa. In addition, this technique has significantly decreased the incidence of contour deformities associated with rib resection as compared with published methods of internal mammary vessel dissection.1 In fact, most published methods have used techniques similar to those outlined by Dr. D'Arpa and his group in this letter. It is critical for us as surgeon-scientists to review our data objectively and without bias rather than anecdotally. Therefore, we encourage Dr. D'Arpa and his team to review their series and publish their results in a peer-reviewed journal.
Babak J. Mehrara, M.D.
Department of Surgery
Memorial Sloan-Kettering Cancer Center
1275 York Avenue
New York, N.Y. 10021
1. Mosahebi A, Da Lio A, Mehrara BJ. The use of a pectoralis major flap to improve internal mammary vessels exposure and reduce contour deformity in microvascular free flap breast reconstruction. Ann Plast Surg
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