الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
In this study we will discuss the specific elements of breast reconstruction by free flaps; by discussing the indications, advantages and disadvantages of techniques of micro vascular breast reconstruction we performed with special care to point to the latest techniques we used to improve the results and minimizing the complications of breast reconstruction using free flaps.
Autologous breast reconstruction provides a long lasting, natural shape; warm and soft result and avoids the increasing complications with breast implants. The transverse rectus abdominis myocutaneous flap had become the gold standard for breast reconstruction in the last decade.
The free deep inferior epigastric perforator (DIEP) flap is a refinement or ”upgrade” of the conventional mycotanous lower abdominal flap. The harvested skin and fat baddles are similar but none of the underlying muscle is scarified. The preservation of the continuity of the muscle fibers, the muscles motor intervention and the vascularisation of collateral blood vessels, ensures normal function of the muscle, only split during surgery, and the muscles that interact with it. Therefore, normal body movements, strength and the abdominal competence will not be affected and patients can continue with their usual activities of daily life.
Spontaneous return of sensation can also be seen in free flaps that were not reinnervated by nerve repair.
The free DIEP demonstrates comparable complication rates as the free TRAM flap. Making these flaps safe and reliable techniques. Although still a very low risk is involved, especially total flap loss, free perforator flap surgery for breast reconstruction in the surgical techniques in which the least peri-and post operative complications are involved and that offers the patient the best long-term aesthetic result. Additionally, sparing the donor site muscle, the normal breast anatomy is imitated in the best possible way and except for a donor site scar, no other damaged is caused to the body. The free DIEP flap is the first choice of breast reconstruction because of the inherent characteristics of the lower abdominal wall. Other perforator flaps as the Glutheal artery perforator flap can be used only in salvage cases or when the DIEP flap is not available.