乳腺整形重建中，体积替代最常使用的是皮瓣移植。在体形轻盈、乳房较小的患者中，自由组织移植可能更适合保留乳房大小。关于微血管乳腺整形重建的证据有限，也经常需要放弃潜在的未来供体部位。自由浅表低腹壁小皮瓣（SLAM）采用了一条狭窄的基于腹壁浅表灌流的下腹部组织条带，在与胸壁穿孔血管吻合的同时，保留了未来基于腹壁的自体乳腺重建的可能性。五名患者接受了使用SLAM皮瓣的即时乳腺整形重建。平均年龄为49.8岁，身体质量指数为23.5。肿瘤位置最常见于下外象限（40%）。平均切除肿瘤大小为30克。两个皮瓣基于下腹部浅表下肺动脉，三个基于腹股沟浅外侧动脉。受体血管包括乳内动脉穿孔支（40%）、锯齿肌分支（20%）、侧胸血管分支（20%）和侧肋间穿孔支（20%）。所有患者均在无延迟的情况下接受了放射治疗，并在手术后平均11.7个月保持了容积、对称性和轮廓。没有皮瓣丧失、脂肪坏死或迟发性创口愈合的情况。自由的SLAM皮瓣可以在有限的区域组织的细瘦小乳房患者中实现即时乳腺整形重建，而且不会牺牲未来的自体乳腺重建的潜在供体部位。Copyright © 2023 by the American Society of Plastic Surgeons.

Volume replacement in oncoplastic breast reconstruction most commonly utilizes pedicled flaps. In thin patients with small breasts, free tissue transfer may be better-suited to preserve breast size. Evidence on microvascular oncoplastic reconstruction is limited and has often required sacrifice of potential future donor sites. The free superficially-based low abdominal mini (SLAM) flap utilizes a narrow strip of lower abdominal tissue based on superficial perfusion of the abdominal wall that is anastomosed to chest wall perforators to preserve the ability to perform future abdominally-based autologous breast reconstruction. Five patients underwent reconstruction with SLAM flaps for immediate oncoplastic reconstruction. Mean age was 49.8 and body mass index was 23.5. Tumor location was most commonly in the lower outer quadrant (40%). Average lumpectomy size was 30 grams. Two flaps were based on the superficial inferior epigastric artery and three on the superficial circumflex iliac artery. Recipient vessels included internal mammary perforators (40%), serratus branch (20%), lateral thoracic vessel branch (20%) and lateral intercostal perforators (20%). All patients underwent radiation therapy without delay and maintained volume, symmetry and contour at an average of 11.7 months after surgery. There were no cases of flap loss, fat necrosis, or delayed wound healing. The free SLAM flap allows for immediate oncoplastic breast reconstruction in thin, small-breasted patients with limited regional tissue without sacrificing future potential donor sites for autologous breast reconstruction.Copyright © 2023 by the American Society of Plastic Surgeons.