Modifications to Extend the Transverse Upper Gracilis Flap in Breast Reconstruction

Saint‐Cyr, Michel; Wong, Corrine; Oni, Georgette; Maia, Munique; Trussler, Andrew P.; Mojallal, Ali; Rohrich, Rod J.

doi:10.1097/prs.0b013e31823620cb

Cited by 46 publications

(41 citation statements)

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“…The pedicle courses in between the adductor magnus and longus muscles to enter the upper gracilis (38,(42)(43)(44). The transverse upper gracilis pedicle is generally short, usually between 6 and 8 cm (44). Preoperative imaging identifies the gracilis pedicles bilaterally and may be used to assess for any variant pedicle anatomic types, such as a single pedicle, a split pedicle, or a double vascular pedicle (Fig 9).…”

Section: Transverse Upper Gracilis Flapmentioning

confidence: 97%

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Modern Perforator Flap Imaging with High-Resolution Blood Pool MR Angiography

et al. 2015

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Advances in microsurgical techniques have improved autologous reconstructions by providing new donor site options while decreasing donor site morbidity. Various preoperative imaging modalities have been studied to assess the relevant vascular anatomic structures, with magnetic resonance (MR) angiography traditionally lagging behind computed tomography (CT) with respect to spatial resolution. Blood pool MR angiography with gadofosveset trisodium, a gadolinium-based contrast agent with extended intravascular retention, has allowed longer multiplanar acquisitions with resultant voxel sizes similar to or smaller than those of CT and with improved signal-to-noise ratio and soft-tissue contrast while maintaining the ability to depict flow with time-resolved imaging. The resultant vascular detail enables precise evaluation of the relevant vascular anatomic structures, including the vessel course, size, and branching pattern, as well as the venous arborization pattern. In addition, any architectural distortion, vessel alteration, or injury from prior surgery can be depicted. The reporting radiologist should be aware of pertinent and incidental findings relevant to the planned surgery and the patient's disease so that he or she can assist the microsurgeon in flap design as a member of the multidisciplinary team. Given the lack of ionizing radiation exposure in patients who often have an elevated body mass index, high-spatial-resolution blood pool MR angiography has become the imaging reference standard for the preoperative assessment of perforator flap vascular and soft-tissue morphology in our practice.

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Section: Transverse Upper Gracilis Flapmentioning

confidence: 97%

“…On occasion, the pedicle may originate directly from the deep femoral vessels (43). The pedicle courses in between the adductor magnus and longus muscles to enter the upper gracilis (38,(42)(43)(44). The transverse upper gracilis pedicle is generally short, usually between 6 and 8 cm (44).…”

Section: Transverse Upper Gracilis Flapmentioning

confidence: 99%

Modern Perforator Flap Imaging with High-Resolution Blood Pool MR Angiography

et al. 2015

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“…6 In addition, the use of a combined transverse and vertical skin paddle has also been described as a means of increasing the flap volume. 7 Finally, the use of a vertical skin paddle has been reintroduced as a viable option in selected patients, potentially avoiding the problems of scar migration and labial spreading. 8 The increasing trend toward skin-sparing mastectomy techniques has limited the skin requirement in many cases, thereby avoiding the need to use the distal thigh skin.…”

Section: Plastic and Reconstructive Surgery • September 2015mentioning

confidence: 99%

TUGs into VUGs and Friendly BUGs

Park

Alkureishi

Song

2015

Plastic and Reconstructive Surgery

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“…Owing to its reliable anatomy, ability to be neurotized, ease of harvest, and low donor-site morbidity, the gracilis flap has become a prime choice for surgeons in smile restoration, and has become a desirable treatment option for patients. 1,2,[9][10][11][12] In a study of 104 patients requiring gracilis flaps, only 6% of patients had persistent weakness that interfered with walking or running, and a <10% donor site complication rate consisting of infection, bleeding, or pain. 13 Besides facial reanimation, gracilis has also been used to fill soft tissue defects in the head and neck, and has also been well served for aesthetic purposes.…”

Section: The Gracilis Free Flap In Head and Neck Reconstruction: A Himentioning

confidence: 99%