Supercharged and Delayed Thoracodorsal and Dorsal Intercostal Artery Perforator Flaps for Autologous Breast Reconstruction.

In patients seeking total autologous breast reconstruction following mastectomy, prior abdominal surgery can present as a contraindication to utilizing traditional abdominal-based free flaps. The thoracodorsal artery perforator (TDAP) flap has emerged as a suitable alternative, providing adequate tissue and minimal donor site morbidity. This case report demonstrates further improvement to this technique by utilizing the dorsal intercostal artery perforator vessels to supercharge this pedicled flap, along with a surgical delay of the TDAP and dorsal intercostal artery perforator. This adaptation can provide added bulk and improved perfusion to the traditional TDAP-based total autologous breast reconstruction.