The Superficial Inferior Epigastric Artery (SIEA) Flap

In Brief The lower abdominal skin and fat have become a standard for breast reconstruction because the abdominal tissue can mimic the breast to a high degree. With today's increasing focus on safety and routine of microsurgical interventions, more attention must be paid to donor-site morbidity. The superficial inferior epigastric artery (SIEA) free flap is the least invasive microsurgical procedure for breast reconstruction because this operative technique does not require harvesting of the rectus muscle or the abdominal fascia. A total of 11 breast reconstructions were performed with this technique and had an average follow-up of 23 months. The anatomy, operative technique, and various indications for the SIEA flaps are demonstrated. Eleven SIEA flap breast reconstructions were performed with satisfactory outcomes and no disruption of the abdominal muscle or fascia. The procedure is recommended except when the vessel is too small, too short, or absent.