DIEP and Muscle Sparing Breast Free Flap

The deep inferior epigastric perforator (DIEP) and muscle-sparing (MS) free transverse rectus abdominis musculocutaneous (TRAM) flaps are arguably the most common flaps used for autologous breast reconstruction. The benefit of these flaps is that very little to no donor site muscle is harvested. The decision to use one or the other is occasionally made preoperatively based on body habitus but often intraoperatively based on the quality of the perforating vessels. The technical aspects of the operation are similar except for the actual dissection around the perforating vessels. Studies have demonstrated no significant differences in outcome when comparing the DIEP and MS free TRAM flaps.