Enhancing Viability of Internal Mammary Artery Perforator Flaps Using Delay Phenomenon: Alsheshi Technique

The introduction of perforator flaps in 1989 opened new possibilities for reconstruction, allowing for primary closure of the donor site and providing superior functional and cosmetic outcomes. This case details the successful application of the delay phenomenon to internal mammary artery perforator flap reconstruction in a left posterior neck third-degree burn victim. This technique enabled us to 1) reliably harvest a long internal mammary artery perforator flap on a single vessel without congestion and 2) maximize aesthetics.