Abdominal-based free flap reconstruction of the breast in a patient with prior cryolipolysis: a case report and literature review

Abdominal-based flaps, including deep inferior epigastric artery perforator and transverse rectus abdominis myocutaneous flaps, are workhorse flaps for autologous breast reconstruction. These flaps are vascularized by perforators originating from the deep inferior epigastric vessels and traversing through the rectus abdominis muscle and subcutaneous tissue to supply the skin. As such, previous abdominal procedures, such as liposuction, may compromise flap perfusion and affect the choice of reconstruction. While there are numerous studies investigating the impact of liposuction on abdominal-based flaps, there is limited data on the implications of cryolipolysis, which is a relatively newer modality of non-invasive body contouring that is gaining increasing popularity. We describe a case of autologous breast reconstruction in a patient who had undergone cryolipolysis, where a free transverse rectus abdominis myocutaneous flap was used as the perforators were too small for reliable perfusion of a deep inferior epigastric artery perforator flap.