Clinical Scenarios in Reconstructive Microsurgery: Strategy and Operative Techniques

Preface
Contents
About the Editors
Section Editors
Contributors
Part I: Head and Neck
	1 Microvascular Reconstruction of Soft Tissue Defects of the Scalp
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	2 Composite Defect of Scalp and Calvarial Bone Following Oncological Resection
		The Clinical Scenario
		Preoperative Problem List- Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome- Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	3 Reconstruction of Calvarial Bone Radionecrosis and Osteomyelitis
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	4 Anterior Skull Base Reconstruction with Intracranial Free Flaps
		Clinical Scenario
		Preoperative Problem List/Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	5 Endoscopic Insetting of Free Flaps in Skull Base Reconstruction
		Clinical Scenario
		Preoperative Problem List/Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
			Postoperative Management
			Outcome, Clinical Photos, and Imaging
			Avoiding and Managing Problems
			Learning Points
		Cross-References
		References
	6 Upper Lip Replantation with Arterialized Venous Flap, Without Microsurgical Venous Outflow
		The Clinical Scenario
		Preoperative Problem List
		Treatment Plan and Alternative Reconstructive Options
			Prophylactic Antibiotics
			Tetanus Prophylactics
			Rabies Prophylactics
			Replantation of the Amputate
			Leech Therapy
			Alternative Reconstruction Techniques
			Abbe Flap
			Estlander Flap
			Karapandzic Flap
		Surgical Technique, Patient Management, and Outcome
		Learning Points
		References
	7 Upper Lip Amputation: Microsurgical Replantation and Postoperative Routine
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images (Figs. 3, 4, and 5)
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	8 Salvaging a Failed Total Nasal Reconstruction Using Radial Forearm and Forehead Flaps
		The Clinical Scenario
		Preoperative Problem List
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Surgical Technique
			First Stage
				Postoperative Course
			Second Stage
				Postoperative Course
			Third Stage
				Postoperative Course
					Intermediate Analysis of Reconstruction Requirements
			Fourth Stage
				Postoperative Course
			Fifth Stage
				Postoperative Course
			Sixth Stage
				Postoperative Course
			Seventh Stage
				Postoperative Course
			Eighth Stage
				Postoperative Course
					Analysis of Final Reconstruction Requirements
			Ninth Stage
			Final Result
		Technical Pearls
		Avoiding and Managing Problems
		Learning Points
		References
	9 SCIP Flap for Tongue Reconstruction
		The Clinical Scenario
		Preoperative Problem List/Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	10 Reconstruction of Partial Glossectomy with Innervated Lateral Forearm Flap
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstruction Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Photographs
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	11 Tongue Reconstruction with Medial Sural Artery Perforator Flap
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	12 Total Lower Face Reconstruction with Double Free Flaps
		Clinical Scenario
		Preoperative Problem List and Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	13 Total Lower Lip Reconstruction with Innervated Radial Forearm Flap and Palmaris Longus Tendon
		The Clinical Scenario
		Preoperative Problem List/Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
			First Stage: Innervated Composite Free Radial Forearm Flap
			Technical Pearls
			Second Stage: Flap Sculpture and Creation of Aesthetic Lip Component
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	14 Ear Replantation
		The Clinical Scenario
		Preoperative Problem List-Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	15 Ear Reconstruction Using Microvascular Techniques
		The Clinical Scenario
		Preoperative Problem List/Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	16 Periauricular Reconstruction After Total Parotidectomy with Facial Nerve Reconstruction and Free Flaps
		The Clinical Scenario
		Preoperative Problem List/Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
			Soft Tissue Reconstruction
			Facial Nerve Reconstruction
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	17 Reconstruction of a Massive Facial Defect Following Trauma
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	18 Mandible Reconstruction in Osteoradionecrosis
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	19 Atrophic Maxilla with Fibula Flap and Implant-Supported Prosthesis
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images (Figs. 8, 9, 10, 11, 12, 13, 14, 15, and 16)
		Postoperative Management
		Outcome Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	20 Reconstruction of Temporomandibular Joint with a Fibula Free Flap
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	21 Orbital Reconstruction with Free Fibula Flap
		The Clinical Scenario
		Preoperative Problem List-Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
			Primary Surgery (Figs. 3, 4, 5, 6 and 7)
			Second Stage (Fig. 8)
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	22 Hypopharynx Reconstruction with a Chimeric Musculocutaneous Anterolateral Thigh Free Flap
		Clinical Scenario
		Preoperative Problem List and Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	23 TPFF Augmentation of Primary Pharyngeal Closure Following Total Laryngectomy
		Clinical Scenario
		Preoperative Problem List/Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique (Video 1)
			Endoscopic-Assisted Harvesting
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome
		Avoiding and Managing Problems
		Learning Points
		References
	24 Utility of Temporoparietal Adipofascial Free Flap in Laryngotracheal Reconstruction
		Clinical Scenario: Temporoparietal Fascial Free Flap for Recurrent T1-T2 Glottic Cancers Treated with Primary Radiotherapy
			Preoperative Problem List/Reconstructive Requirements
			Treatment Plan
			Alternative Reconstructive Options
			Preoperative Evaluation and Imaging
			Preoperative Care and Patient Drawing
			Surgical Technique
			Technical Pearls
			Intraoperative Images
			Postoperative Management
			Outcome
			Avoiding and Managing Problems
			Learning Points
		References
	25 Complex Neck Allotransplantation
		The Clinical Scenario
		Preoperative Problem List
		Treatment Plan
			Alternative Reconstructive Options
			Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	26 Adult Facial Nerve Palsy Reconstruction Using Gracilis Functional Muscle Innervated with Cross-Face Nerve Graft
		The Clinical Scenario
		Preoperative Problem List /Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
			First Stage: Cross-Face Nerve Grafting (CFNG)
				Sural Nerve Harvest
				Facial Nerve Branch Identification and Preparation of Pockets
			Second Stage: Facial Reanimation with Gracilis Flap
				Face: Preparing the Recipient Site
				Right Medial Thigh: Harvesting the Gracilis Muscle
				Positioning of the Gracilis Muscle at Recipient Site
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome, Clinical Photos, and Imaging (Figs. 10, 11, 12, 13, 14, 15 and 16)
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	27 Adult Facial Palsy Reconstruction: Dual Innervation of Gracilis Muscle
		The Clinical Scenario
			History
		Preoperative Problem List- Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
			First Stage
			Second Stage
			Surgical Technique
		Technical Pearls
		Intraoperative Photographs
			Post-Operative Management
		Outcomes-Clinical Photos and Imaging
			Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	28 Facial Reanimation in Congenital Facial Palsy (Moebius Syndrome)
		Clinical Scenario
		Preoperative Problem List
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Care and Patient Drawing
		Surgical Technique
			First Stage
			Second Stage
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	29 One-Stage Reconstruction of Facial Paralysis Using Masseter Nerve-Innervated Gracilis
		Clinical Scenario
		Preoperative Problem List
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points (5)
		Cross-References
		References
	30 Midface Reconstruction with Soft Tissue and Bone Flaps
		Soft Tissue Reconstruction
			The Clinical Scenario
			Preoperative Problem List/Reconstructive Requirements
			Treatment Plan
			Alternative Reconstructive Options
			Preoperative Evaluation and Imaging
			Preoperative Care and Patient Drawing
			Surgical Technique
			Technical Pearls
			Intraoperative Images
			Postoperative Management
			Outcome, Clinical Photos, and Imaging
			Avoiding and Managing Problems
			Learning Points
		Osteocutaneous Reconstruction
			The Clinical Scenario
			Preoperative Problem List/Reconstructive Requirements
			Treatment Plan
			Alternative Reconstructive Options
			Preoperative Evaluation and Imaging
			Preoperative Care and Patient Drawing
			Surgical Technique
			Technical Pearls
			Intraoperative Images
			Postoperative Management
			Outcome, Clinical Photos, and Imaging
			Avoiding and Managing Problems
			Learning Points
		Cross-References
		References
	31 Free Fibula Flap Reconstruction of the Cervical Spine
		The Clinical Scenario
		Preoperative Problem List and Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Postoperative Management
		Outcome
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	32 Virtual Surgical Planning and CAD/CAM for Mandible and Maxilla Reconstruction with Free Fibula Flap
		Mandibular Reconstruction Using VSP
			The Clinical Scenario
			Preoperative Problem List/Reconstructive Requirements
				Osseous Defect
				Soft Tissue Defect
				Recipient Vessels
			Treatment Plan
			Alternative Reconstructive Options
			Preoperative Evaluation and Imaging
				Breaking Down VSP/CAD-CAM
				Workflow Used (Fig. 2)
				In-House Versus External Planning
			Preoperative Care and Patient Drawing
			Surgical Technique
			Technical Pearls
			Intraoperative Images (Figs. 8, 9, and 10)
				Postoperative Management
			Outcome, Clinical Photos, and Imaging
			Avoiding and Managing Problems
			Learning Points
		Maxillary Reconstruction Using VSP
			The Clinical Scenario
			Preoperative Problem List/Reconstructive Requirements
			Preoperative Evaluation and Imaging
			Surgical Techniques
			Intraoperative Images (Figs. 18 and 19)
				Outcome, Clinical Photos, and Imaging
			Learning Points
		Cross-References
		References
	33 Vascularized Vastus Lateralis Nerve Graft for Reconstruction of Composite Facial Nerve Defect
		The Clinical Scenario
		Preoperative Problem List/Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome, Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		Disclosure
		Cross-References
		References
	34 Aesthetic Subunit Microvascular Reconstruction of the Cheek
		The Clinical Scenario
		Preoperative Problem List/Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
			Large Skin and Soft Tissue Defect
			Malar Proeminence Deficiency
			Facial Nerve Reconstruction and Reconstruction of Mimetic Muscles of Midface
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	35 SCIP Flap for Simultaneous Management of Orocutaneous Fistula and Facial Lymphedema
		The Clinical Scenario
		Preoperative Problem List / Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	36 Reconstruction of Total Maxillectomy and Orbital Floor with a Free Scapula Tip Flap
		The Clinical Scenario
		Preoperative Problem List /Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images (Figs. 4, 5, 6, 7, and 8)
			Postoperative Management
			Outcome, Clinical Photos, and Imaging
			Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	37 Reconstruction of Mandible and Hemiglossectomy with a Chimeric Scapula Tip and TDAP Flap
		The Clinical Scenario
		Preoperative Problem List/Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Surgical Technique
		Technical Pearls
		Intraoperative Images (Figs. 3 and 4)
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	38 Double Free Flap Reconstruction in the Complex Neck
		The Clinical Scenario
		Preoperative Problem List/Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	39 Management of Bone Nonunion in Mandible Free Flaps with a Scapular Tip Flap
		The Clinical Scenario
		Preoperative Problem List/Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
			Medical Therapy
			Alternative Bony Flaps
				Fibula Osseocutaneous Flap
				Deep Circumflex Iliac Artery (DCIA) Iliac Crest Flap
				Medial Femoral Condyle Flap
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images (Figs. 3 and 4)
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
Part II: Upper Extremity
	40 Complex Thumb Reconstruction Using Free Chain-Linked ``Mini Wraparound´´ Great Toe and Dorsalis Pedis Flaps
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	41 Free ``Wrap-Around´´ Great Toe Flap for Thumb Reconstruction After Avulsion Injuries
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome-Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	42 Combined Osteodistraction and Free ``Mini Wraparound´´ Great Toe Flap for Thumb Reconstruction After Amputation at the Meta...
		The Clinical Scenario
		Preoperative Problem List-Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome-Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	43 First Toe-to-Hand Transfer and the Forearm Radial Flap as Chain-Linked Flaps for Thumb Reconstruction After Amputation
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstruction Options
			Moment of Reconstruction
			Type of Reconstruction for the Thumb and Skin Defect
		Preoperative Evaluation
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome: Clinical Photos
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	44 Serratus Anterior-Rib Flap for the Reconstruction of Complex Defects Involving the First Metacarpal
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstruction Options
			Moment of Reconstruction
			Type of Reconstruction for the Thumb and Skin Defect
			Preoperative Evaluation
			Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome: Clinical Photos
		Avoiding and Managing Problems
		Learning Points
		References
	45 Free PIP Joint Transfer for Functional Finger Reconstruction
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
			Hand
			Foot
		Intraoperative Images
		Postoperative Management
			Hand
			Foot
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problem
		Learning Points
		Cross-References
		References
	46 Treatment of Scaphoid Nonunion Using the Free Corticocancellous Lateral Femoral Condyle Bone Flap
		Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Surgical Technique
			Preparation of the Recipient Site
			Flap Harvesting
			Scaphoid Reconstruction
		Technical Pearls
		Postoperative Management
		Outcomes
		Avoiding and Managing Problems
		Learning Points
		References
	47 Treatment of the Avascular Necrosis of the Lunate Using a Free Vascularized Corticocancellous Bone Graft from the Lateral F...
		Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstruction Options
		Preoperative Evaluation and Imaging
		Surgical Technique
			Preparation of the Recipient Site
			Flap Harvesting
			Lunate Reconstruction
		Technical Pearls
		Postoperative Management
		Outcomes
		Avoiding and Managing Problems
		Learning Points
		References
	48 Treatment of Kienböck´s Disease Using Free Vascularized Cartilage Bone Flaps from the Lateral Femoral Condyle
		The Clinical Scenario
		Preoperative Considerations: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome- Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	49 Augmentation of Bone Allograft with Vascularized Medial Femoral Condyle Periosteal Flap in Radius Reconstruction
		Clinical Scenario
		Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Surgical Technique
		Technical Pearls
		Intraoperative Images
			Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	50 Free Medial Femoral Condyle Flap for Salvage Arthrodesis of Carpal Osteomyelitis
		The Clinical Scenario
			Preoperative Problem List: Reconstructive Requirements
				Treatment Plan
		Alternative Reconstructive Options
			Preoperative Imaging
			Preoperative Marking
		Operative Technique
			Flap Harvest
			Flap Inset and Osteosynthesis
		Technical Pearls and Avoiding Problems
		Intraoperative Images
			Postoperative Management
		Outcome: Clinical Photos and Imaging
			Learning Points
		References
	51 Reconstruction of the Upper Extremity Using Free Proximal Fibula Flap after Sarcoma Resection
		The Clinical Scenario
		Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Anatomy
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome-Clinical Photos and Imaging
		Avoiding and Managing Problems
		References
	52 Transverse Sensate Thoracodorsal Artery Perforator Flap for Finger Reconstruction
		Patient 1: Reconstruction of a Dorsal Finger Defect
			The Clinical Scenario
			Preoperative Problem List/Reconstructive Requirements
			Treatment Plan
			Alternative Reconstructive Options
			Preoperative Evaluation and Imaging
			Preoperative Care and Patient Drawing
			Surgical Technique
				Position of Patient
				Design of Flap
				Flap Elevation
				Preparation of Recipient Wound, Nerve, and Vessels
				Microsurgical Coaptation of the Nerve and Vessels
				Wound Closure
			Technical Pearls
			Intraoperative Images
			Postoperative Management
			Outcome, Clinical Photos, and Imaging
			Avoiding and Managing Problems
			Learning Points
		Patient 2: Reconstruction of a Palmar Finger Defect
			The Clinical Scenario
			Preoperative Problem List/Reconstructive Requirements
			Treatment Plan
			Alternative Reconstructive Options
			Preoperative Evaluation and Imaging
			Preoperative Care and Patient Drawing
			Surgical Technique
			Technical Pearls
			Intraoperative Images
			Postoperative Management
			Outcome, Clinical Photos, and Imaging
			Avoiding and Managing Problems
			Learning Points
		Patient 3: Reconstruction of a Circumferential Thumb Defect
			The Clinical Scenario
			Preoperative Problem List/Reconstructive Requirements
			Treatment Plan
			Alternative Reconstructive Options
			Preoperative Evaluation and Imaging
			Preoperative Care and Patient Drawing
			Surgical Technique
			Technical Pearls
			Intraoperative Images
			Postoperative Management
			Outcome, Clinical Photos, and Imaging
			Avoiding and Managing Problems
			Learning Points
		Cross-References
		References
	53 Extracutaneous Free Triple Split SCIP Flap for Simultaneous Reconstruction of Multiple Soft Tissue Defects of the Fingers
		The Clinical Scenario
		Preoperative Problem List - Reconstructive Requirements
		Treatment Plan
		Alternative Treatment Plan
		Preoperative Evaluation and Imaging
		Preoperative Care and Flap Marking
		Surgical Technique
			Initial Debridement on the Day of Injury
			Reconstruction of Vital Structures
			Preparation of the Recipient Vessels
			Flap Elevation
			Flap Anastomosis
			Flap Thinning Procedure
		Technical Pearls
		Intraoperative Imaging
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	54 Reconstruction of Palm Defects in Children Using Microsurgical Free Flaps
		First Patient Clinical Scenario
			Preoperative Problem List: Reconstructive Requirements
			Treatment Plan
			Alternative Reconstructive Options
			Preoperative Evaluation and Imaging
			Preoperative Care and Patient Drawing
			Surgical Technique
			Technical Pearls
			Intraoperative Images
			Postoperative Management
			Outcome: Clinical Photos and Imaging
		Second Patient Clinical Scenario
			Preoperative Problem List: Reconstructive Requirements
			Treatment Plan
			Alternative Reconstructive Options
			Preoperative Evaluation and Imaging
			Preoperative Care and Patient Drawing
			Surgical Technique
			Technical Pearls
			Intraoperative Images
			Postoperative Management
			Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points and Special Measures for the Success of a Free Flap in Pediatric Patients
		Cross-References
		References
	55 Thin Free Flap for Resurfacing of the Arm and Forearm
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Postoperative Management
		Outcome: Clinical Photo and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	56 Major Amputations at the Arm and Forearm Level: Replantation Strategy and Technique
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcomes
		Avoiding and Managing Problems
		Learning Points: Maximum of Five Learning Points
		References
	57 Reconstruction of Complex Finger Defects Using the Free Ulnar Artery Perforator Flap
		Introduction
		The Clinical Scenario
		Treatment Plan: Reconstructive Requirements
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Postoperative Management
		Avoiding and Managing Problems
		References
	58 Complete Brachial Plexus Lesion: Multistaged Reconstruction of the Sensory-Motor Function
		The Clinical Scenario
		Preoperative Problem List/Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
			Third Stage
		Surgical Technique
			First Stage
			Second Stage
			Third Stage
			Fourth Stage
		Technical Pearls
		Postoperative Management
			Third Stage
			Fourth Stage
		Outcome, Clinical Photos, and Imaging: Functional and Aesthetic Outcomes
		Avoiding and Managing Problems
		Learning Points
		References
	59 Adult Immediate Brachial Plexus Reconstruction
		The Clinical Scenario
		Preoperative Problem List/Reconstructive Requirement
		Treatment Plan
			Patient Selection
			Time of Surgery
			Available Donor Nerves
			Treatment Goals
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	60 Brachial Plexus Secondary Reconstruction with Contralateral C7
		The Clinical Scenario
		Preoperative Problem List/Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Marking
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Complications
		Learning Points
		References
Part III: Lymphedema
	61 Combined Autologous Breast and Lymphedema Reconstruction with a Predesigned DIEP and Lymph-Node Flap
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	62 Submental Lymph Node Transfer to the Lower Extremity
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	63 LYMPHA Approach for Axillary Clearance Surgery
		The Clinical Scenario
		Preoperative Problem List
		Treatment Plan
		Alternative Reconstruction Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome, Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		Conclusions
		References
	64 Supermicrosurgical Lymphaticovenular Anastomosis (LVA) for Early-Stage (Stage 1-2) Extremity Lymphedema
		The Clinical Scenario
		Preoperative Problem List
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique and Intraoperative Images
		Technical Pearls
		Postoperative Management
		Outcome
		Avoiding and Managing Problems
		Learning Points
		References
	65 Lateral Thoracic Artery Lymph Nodes (LTLN) for Lower Limb Lymphedema
		Clinical Scenario
		Treatment Plan
		Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique and Technical Pearls
		Intraoperative Images and Outcomes
		Postoperative Management
		Clinical Outcome
		Learning Points
		References
	66 Free Transfer of Cervical Lymph Nodes to a Lower Limb Lymphedema
		Case Scenario
		Preoperative Problem List
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care
		Surgical Technique
			Vascular Anatomy of Submandibular Lymph Nodes
			Operative Procedure (Video) (Tan et al. 2016)
			Revascularization of the Lymph Node Flap at the Recipient Site
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcomes, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
Part IV: Lower Extremity
	67 Soft-Tissue Reconstruction in Exposed Total Knee Arthroplasty
		The Clinical Scenario
			Preoperative Problem List/Reconstructive Requirements
				Infection
				Reconstructive Surgery
			Treatment Plan
				Infection Elimination
				Reconstructive Surgery Including Alternative Reconstructive Options
			Preoperative Evaluation and Imaging
				Conventional Radiograph
				Arteriography
				Angiological Examination
				Handheld Doppler
			Preoperative Care and Patient Drawing
				Surgical Technique
				Free ALT Flap
			Technical Pearls
				Donor Vessels
				Intraoperative Images
			Postoperative Management
			Outcome, Clinical Photos, and Imaging
			Avoiding and Managing Problems
			Learning Points
		References
	68 Tibial Tuberosity Coverage Using Venous Supercharged Distally Based Pedicled ALT Flap
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	69 Complete Peroneal Nerve Palsy: Functional Reconstruction with Tendon Transfers
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	70 Tibial Bone Defect Reconstruction with Ilizarov and Free Flap
		The Clinical Scenario
		Reconstructive Requirements
		Treatment Plan
		Alternative Treatment Options
		Preoperative Medical Status, Evaluation, and Imaging
		Treatment Strategy and Surgical Technique
			Stage I
		Postoperative Management
			Stage II
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Learning Points
			Avoiding and Managing Problems
		Cross-References
		References
	71 Reconstruction of Plantar Heel Defect
		Clinical Scenario
		Preoperative Problems/Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome and Clinical Photos
		Avoiding and Managing Problems
		Learning Points
		References
	72 Plantar Weight-Bearing Area Defects Reconstructed with Perforator Flap
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
			Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	73 Plantar Weight-Bearing Area Defects Reconstructed with Muscle Flap
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
			Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	74 Lower Limb Transplantation
		The Clinical Scenario
		Preoperative Problem List/Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	75 Thigh Sarcoma Reconstruction with Free Functional Latissimus Dorsi Piggyback onto Rectus Abdominis Flap
		The Clinical Scenario
		Preoperative Problem List/Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Surgical Technique
			Primary Reconstruction with Functional Rectus Abdominis Transfer
			Secondary Reconstruction with Free Functional Latissimus Dorsi Flap
		Technical Pearls
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	76 Diabetic Foot Reconstruction Using SCIP Flap
		Clinical Scenario
		Preoperative Problem Lists: Reconstructive Requirement
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Reconstructive Technique
		Technical Pearls
		Intraoperative Images (Figures 8, 9, 10, and 11)
		Postoperative Management
		Outcome-Clinical Photo and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	77 Femur Reconstruction with a Modified Masquelet Technique
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
Part V: Breast/Trunk
	78 Composite Axillary Defect After Sarcoma Resection: Reconstruction with Anterolateral Thigh Flap
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	79 Anterolateral Thigh (ALT) Free Flap Reconstruction of a Complex Chest Wall Defect
		Introduction
		Illustrated Case Report
		Radiological Investigations
		Intraoperative Sequence for the ALT Flap Harvest
		Recipient Vessel Exposure: The Internal Mammary Vessels
		Skeletal Reconstruction
		Microsurgery: Anastomoses
		Microanastomoses
		Postoperative Follow-up
		Contributing Factors to Case Complexity
		Technical Pearls
		References
	80 Anterolateral Thigh Flap for Poland´s Syndrome
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	81 Abdominal Wall Reconstruction
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique and Intraoperative Images
			PMP Tumor Resection
			AW-VCA Retrieval
			Vascular Anastomosis
		Technical Pearls
		Postoperative Management
			Postoperative Monitoring for AW-VCA Ischemia
			Postoperative Monitoring for AW-VCA Acute Cellular Rejection
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	82 Abdominal Wall Reconstruction Postsarcoma Excision
		Clinical Scenarios
			Case 1
		Preoperative Problem List/Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options (Table 3)
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	83 Total Vaginal Reconstruction After Total Pelvic Exenteration
		The Clinical Scenario
		Preoperative Problem List/Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	84 Penile Reconstruction with a Free Radial Artery Forearm Flap (FRAFF) for Bladder Exstrophy
		Clinical Scenario
		Preoperative Considerations: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
			The Anterolateral Thigh (ALT) Flap
			Abdominal Flap
			Groin/Superficial Circumflex Iliac Artery Perforator (SCIP) Flaps
		Preoperative Evaluation
		Preoperative Care and Patient Drawings
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome
		Avoiding and Managing Problems
		Learning Points
		References
	85 Areola-Sparing Mastectomy and Deep Inferior Epigastric Perforator Flap Reconstruction
		Introduction
		Clinical Scenario
		Preoperative Problem List/Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	86 DIEP Flap Reconstruction in a Slim Patient
		Clinical Scenario
		Preoperative Problem List/Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	87 Breast Reconstruction with PAP Flap
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	88 Breast Reconstruction with Lumbar Artery Perforator Flap
		The Clinical Scenario
		Preoperative Problem List - Reconstruction Requirements
		Treatment Plan
		Alternative Reconstruction Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Photos
		Postoperative Management
		Outcome and Clinical Photos
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	89 Secondary Breast Reconstruction with Vertical Posteromedial Thigh Flap (vPMT)
		The Clinical Scenario
		Preoperative Problem List/Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	90 SIEA Flap for Breast Reconstruction
		The Clinical Scenario
		Preoperative Problem List /Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Images (Figs. 3, 4, 5, and 6)
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	91 Superior Gluteal Artery Perforator Flap for Immediate Breast Reconstruction
		The Clinical Scenario
		Preoperative Problem List: Reconstruction Requirements
		Treatment Plan
		Alternative Reconstruction Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Photos (Figs. 4 and 5)
		Postoperative Management
		Outcome and Clinical Photos
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	92 Superior Gluteal Artery Perforator (SGAP) Flap in Delayed Autologous Breast Reconstruction
		Clinical Scenario
		Preoperative Problem List /Reconstructive Requirements:
		Treatment Plan
			Advantages
		Alternative Reconstructive Options
		Preoperative Evaluation /Imaging
		Patient Positioning and Markings
		Surgical Technique
		Technical Pearls
		Intraoperative Images
		Outcome: Clinical Photographs
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	93 Stacked Free Flaps for Breast Reconstruction
		Background
		The Clinical Scenario
		Preoperative Problem List: Reconstruction Requirements
		Treatment Plan
		Alternative Reconstruction Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Steps
		Technical Pearls
		Intraoperative Photos
		Postoperative Management
		Outcome and Clinical Photos
		Avoiding and Managing Problems
		Learning Points
		References
	94 Partial Mastectomy Reconstruction with Pedicled Thoracodorsal Artery Perforator Flap
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Techniques
			First Stage
			Second Stage
		Technical Pearls
		Intraoperative Images
		Postoperative Management
		Outcome-Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	95 Bilateral Breast Reconstruction with the Free Fasciocutaneous Infragluteal Flap (FCI)
		Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Treatment Plan
		Preoperative Evaluation and Imaging
		Preoperative Care and Flap Marking
		Surgical Technique
		Technical Pearls
		Intraoperative Imaging
		Postoperative Management
		Outcome: Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	96 Breast Sarcoma Case: ALT and LTP Flaps in the Management of Bilateral Asynchronous Breast Angiosarcoma
		The Clinical Scenario
		Preoperative Problem List/Reconstructive Requirements
		Treatment Plan
			Primary Treatment in Breast Angiosarcoma
			Recurrence in Breast Angiosarcoma
		Alternative Reconstructive Options
		Preoperative Evaluation and Imaging
		Surgical Technique
			Primary Reconstruction with ALT Flap
			Recurrence and Secondary Reconstruction
		Technical Pearls
		Postoperative Management
		Outcome, Clinical Photos, and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	97 Intraoperative Perforator Avulsion in Free Flap Breast Reconstruction
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
		Treatment Plan
		Alternative Autologous Reconstructive Options
		Preoperative Evaluation and Imaging
			Clinical Evaluation
			Imaging Techniques
		Preoperative Care and Patient Drawing
		Surgical Techniques
		Technical Pearls
		Postoperative Management
		Outcome Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	98 Deep Inferior Epigastric Artery Perforator (DIEaP) Flap Harvest After Full Abdominoplasty
		The Clinical Scenario
		Preoperative Problem List - Reconstructive Requirements
		Treatment Plan
		Alternative Autologous Reconstructive Options
			Thigh
			Lower Back/Buttock
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Postoperative Management
		Outcome-Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
	99 Perineal Reconstruction for a Complex Perineal Defect
		The Clinical Scenario
		Preoperative Problem List: Reconstructive Requirements
			Preoperative Planning/Workup
			Defect Composition
			Options for Reconstruction Available/Precluded
			Intraoperative Requirements
		Treatment Plan
		Alternative Reconstructive Options
			Small and/or Superficial Defects
			Large and Complex Defects
				Abdominal
				Gluteal
				Thigh
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique and Intraoperative Images
		Technical Pearls
		Postoperative Management
		Outcome-Clinical Photos and Imaging
		Avoiding and Managing Problems
		Learning Points
		References
	100 Breast Reconstruction Using a Transverse Upper Gracilis Flap
		The Clinical Scenario
		Preoperative Problem List: Reconstruction Requirements
		Treatment Plan
		Alternative Reconstruction Options
		Preoperative Evaluation and Imaging
		Preoperative Care and Patient Drawing
		Surgical Technique
		Technical Pearls
		Intraoperative Photos
		Postoperative Management
		Outcome and Clinical Photos
		Avoiding and Managing Problems
		Learning Points
		Cross-References
		References
Index