Salvage of SIEA flaps using the retrograde internal mammary system

Superficial inferior epigastric artery (SIEA) flaps are ideal for breast reconstruction when the anatomy permits it. Due to the peripheral and superficial location of the pedicle, these flaps can be complicated by vessel kinking against the remaining ribs after insetting. Here, we describe a novel method for SIEA flap salvage after kinking or avulsion of the traditional anastomosis to the internal mammary vessels.