Usability of Imaging Modalities for DIEP/SIEA Flap Design and Planning

A demand for perforator flaps such as the DIEP flap and SIEA flap has increased to reduce donor site morbidity in breast reconstruction. Still, these flaps are harvested based on surgical sensibilities, personal experience, and subjective observations. Nowadays, there are new and conventional imaging modalities, such as CT angiography, duplex ultrasound, and ICG devices, to give a surgeon objective information and guide to reduce the risk of flap compromise. Moreover, these imaging modalities will provide a backup plan in case of flap perfusion problems. In this chapter, I would like to introduce the advantages of these imaging devices for the DIEP and SIEA flap design. In addition, step-by-step flap designs using these devices will be provided.