The gold standard for autologous reconstruction in the post-mastectomy patient remains the deep inferior epigastric artery perforator flap, although many women may not be candidates for abdominally based free tissue transfer. In this scenario, there are several other donor site options based from the thigh (transverse and diagonal upper gracilis flaps, profunda artery perforator flap, lateral thigh flap) and trunk (lumbar artery perforator flap, superior and inferior gluteal artery perforator flaps). This study will review the history, relevant anatomy, surgical technique and outcomes for alternative flaps in autologous reconstruction.Additionally, preoperative imaging (CTA, MRA) and novel applications (stacking flaps, neurotization) in breast reconstructive microsurgery will be discussed.
mentor with skills, knowledge, and experience provides advice, guidance, and support to his or her mentee. 1,2 In plastic surgery, mentorship impacts a variety of domains, including clinical acumen, academic proclivity, business management, and personal life. 3 It is clear that mentorship is a critical tool for professional development and career success, 3,4 as supportive mentorship affords higher job satisfaction, academic productivity, and diversity and inclusion. 1,[4][5][6] It protects against increasing burnout and academic surgery attrition rates. [6][7][8][9][10] Mentorship is especially important in academic medicine, as it is estimated that fewer than 10 percent of physicians entering academia will remain there throughout their career, 8 primarily because of increasing personal sacrifices and professional demands. Women, underrepresented minorities, and junior plastic surgeons are at higher risk, reporting lower job satisfaction and fewer mentorship opportunities. 6,9,[11][12][13][14] Given the unique challenges these groups face in a constantly changing health care system, the importance of mentorship cannot be overstated.Although mentorship is well studied among medical students 15,16 and physicians-in-training, 7 few data exist for those already in practice despite the established benefits. 1 Given that this is a highrisk group, we sought to obtain more information on this group's perceived importance of mentorship through a survey of American Society of Plastic Surgeons' members. The goals of this study are to describe the current state of mentorship in plastic surgery, determine why plastic surgeons believe it is important in all stages of one's career,
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