Breast Reconstruction with Non-Abdominal–Based Free Tissue Flaps

Abstract

Abdominal-based free tissue transfer accounts for the majority of autologous breast reconstruction. In situations where abdominal sources are unavailable, other donor sites should be considered. In this chapter, alternative donor sites for autologous breast reconstruction are discussed, specifically, gluteal- and thigh-based flaps. The superior gluteal artery perforator (SGAP) and inferior gluteal artery perforator (IGAP) flaps are discussed from the gluteal donor site, and the transverse upper gracilis (TUG), profunda artery perforator (PAP), and the lateral thigh perforator (LTP) flaps are discussed from the thigh donor site. Relevant anatomy and surgical technique are discussed for each flap in order to enhance awareness of secondary flap options in the plastic surgeon’s armamentarium for breast reconstruction.