Case report demonstrates successful cephalic vein transposition during delayed DIEP flap breast reconstruction, highlighting an effective alternative when internal mammary veins are compromised.
The internal mammary vessels are the preferred recipient vessels for free-flap breast reconstruction, particularly in delayed reconstruction, in which the thoracodorsal system may be compromised. However, anatomic variation, prior surgical disruption, and radiation-induced fibrosis can render the internal mammary vein unsuitable for venous outflow. We report the successful use of cephalic vein transposition as an alternative recipient vein during delayed breast reconstruction with a deep inferior epigastric artery perforator free flap. This case underscores the importance of preoperative planning for alternative venous options when unexpected intraoperative venous insufficiency is encountered.
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Jung et al. (2026) studied this question.
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