Double-pedicle TRAM flap breast reconstruction: following Bostwick's principles

After using various techniques with various results, Bostwick's principles for breast reconstruction were used in mastectomy cases and their early results are presented. The breast reconstructions were performed to 12 cases, of which eight patients had one or two risk factors and four had more. The double-pedicle technique was used in the former and vascular delay preceding double-pedicle technique was used in the latter. No vascular compromises, arterial or venous, were observed on the flaps in the acute phase and no fat necrosis ensued lately. All patients were satisfied with these principles and we did not observe any problems with the flaps. We have concluded that Bostwick's principles offered a reliable and minimal risk basis for breast reconstructive surgeons.