Based on our anatomical assessment of the vascular pedicle of the internal mammary artery perforator (IMAP) flap, we previously concluded that this flap is well suited for the reconstruction of head and neck defects.1 Like other regional skin flaps such as the deltopectoral flap and the supraclavicular flap,2 the IMAP flap provides skin cover with superior colour match in the head and neck receptor region. Unlike the (segmental) pectoralis major myocutaneous flap,3 however, this flap is thin and pliable, adapting easily to the subtle contour and mobility of the suprasternal and maxillofacial structures. Additionally, the IMAP flap leads to limited morbidity and its donor site may be closed primarily in most cases.
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