DIEP-flap failure after pedicle division three years following transfer

Flap neovascularisation is generally believed to make free skin-containing flaps independent of their axial pedicle blood supply. A case of DIEP-flap failure 3 years after transfer is presented in a breast reconstruction patient in whom a lateral breast reduction for symmetry improvement was performed. Causative factors in this patient were the division of the flap pedicle during lateral breast reduction and smoking in the postoperative period. A review of literature is presented and highlights the uniqueness of this case.