Superior epigastric artery perforator (SEAP) flap: A novel approach to autologous breast reconstruction

Background: Although free tissue breast reconstruction has been increasingly used, it remains challenging to perform outside of specialized centers due to facility and personnel limitations. We describe a preclinical study highlighting the feasibility of a pedicled, superior epigastric artery perforator (SEAP) flap utilizing lower abdominal tissues similar to a transverse rectus abdominus myocutaneous (TRAM) reconstruction, but with decreased donor-site morbidity. Methods: Fresh cadavers were dissected generating a total of 32 SEAP flaps. These flaps were subsequently studied for transposition potential and vascularity utilizing computed tomographic (CT) imaging. Results: An obvious, single, dominant SEAP was appreciated, and a developed flap was routinely capable of reaching either nipple-areola complex with simple interposition. Cadaveric CT imaging revealed global contrast filling in each dissected hemi-abdomen tested. Conclusions: We describe a preclinical study utilizing a novel pedicled, SEAP flap for aesthetic breast reconstruction. While this will not obviate the use of free tissue transfer, it may add to the surgical armamentarium for aesthetic restoration in the breast cancer patient. (C) 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.