DESIGN OF THE INNER THIGH RECONSTRUCTION
The tissue from the inner thigh is removed with some underlying skin, fat and expendable gracilis muscle. The flap is then sculpted to a circular shape with some conical projection. This is outlined in figures A, B and C below. The flap as it is shaped in C can be placed in the breast pocket of the mastectomy, and circulation is reestablished microsurgically to the internal mammary blood vessels. Just like in the DIEP and SIEA procedures further shaping is done to match the opposite breast as closely as possible.
In cases of immediate reconstruction, where a skin sparing areolar incision is performed, immediate nipple areola reconstruction can be done with the inner thigh flap.
The inner thigh lift is performed during the reconstruction, with the thigh wound closed under some tension. The patient is asked not to abduct (spread apart) their legs for several days. Over the course of the in hospital stay, the tension on the incision site begins to soften and the patient resumes a recovery similar to the DIEP or SIEA flap patient.