Internal mammary artery perforator flap for head and neck reconstruction

Abstract

The internal mammary artery perforator (IMAP) flap is a useful modification of the classic deltopectoral flap that has a number of important roles in head and neck reconstruction. In this report, we describe the technique used to plan and raise the flap and demonstrate its use in three different clinical scenarios. The IMAP flap is a pedicled fasciocutaneous flap that is based on single or multiple internal mammary artery perforators. As such, it provides thin pliable tissue with a wide arc of rotation that is suitable for cutaneous, pharyngeal and tracheostomal reconstruction. Moreover, the flap is well-vascularised, reliable and the donor site can be closed primarily.