Avulsion of vascular anastomosis in free-flap breast reconstruction

We report a case of anastomotic avulsion following a free deep inferior epigastric perforator (DIEP) flap reconstruction immediately after mastectomy for carcinoma of the breast. This occurred on the 5th postoperative day when the patient was allowed a shower and abducted her shoulders to wash her hair. The aim of this report is to make readers aware of such a possibility, and we suggest exercising caution in early mobilisation of the upper limb after free-flap breast reconstruction.