Thoracodorsal vessels as a recipient site

A variety of useful recipient vessel options exist for delayed breast reconstruction. The thoracodorsal vessels of the subscapular trunk, however, present the best option in immediate breast reconstruction, in particular for the transverse rectus abdominis myocutaneous (TRAM) flap, because of their consistent availability and reliability. One fundamental surgical advantage of the microvascular approach to breast reconstruction is the relative ease of obtaining consistently high-quality recipient vessels throughout the axilla and anterolateral chest wall to facilitate a predictably successful reconstructive outcome. This article discusses the process of selecting the best vessels and the techniques for their dissection.