Microsurgery: Transplantation and Replantation by Harry J. Buncke, MD, et al.
  Table of Contents / Chapter 7:
Bilateral Inferior Epigastric Flap (BIEF)

Case Reports


This case is from LeQuang's original series, and is used by courtesy of Dr. C. LeQuang.

FIG. 7-01. The BIEF is used to reconstruct a large bilateral facial burn scar.

FIG. 7-02. Superficial inferior epigastric pedicles have been outlined on the abdomen and the flap elevated.

FIG. 7-03. The flap is isolated on the bilateral pedicles.

FIG. 7-04. The postoperative result shows markedly improved soft tissue coverage.

FIG. 7-05. Moderate hairy growth, though curly, further camouflages the transplant.

FIG. 7-06. The donor site scars are well hidden along the inguinal creases.


A woman had severe burn scar contractures of the neck, chin, and lower lip.

FIG. 7-07. The contractures persist after multiple previous skin grafts and releases.


FIG. 7-08. The lateral view emphasizes the deformity.

FIG. 7-09. The dimensions of excision are measured before marking the abdomen.

FIG. 7-10. The BIEF is outlined, with the superficial epigastric pedicles marked.

FIG. 7-11. The flap is elevated superficial to the external oblique fascia. The paired vascular pedicles are exposed.

FIG. 7-12. The recipient site after release of the neck and lip contractures.

FIG. 7-13. The flap above the neck defect. The superior thyroid vessels were used for bilateral recipient blood supply.

FIG. 7-14. Immediate postoperative appearance.

FIG. 7-15. Follow-up results after successful revascularization. Front view.

FIG. 7-16. Lateral view.

FIG. 7-17. Late follow-up after serial debulking with liposuction. Lateral scar z-plasties and a chin implant have helped the final appearance. Front view.

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