The autors relate their experience in breast reconstruction with the use of free {TRAM} flaps with vascular microanastomosis between the deep inferior epigastric system and the internal mammary system. So far, we have treated seven patients with this technique and in all cases we were able to perform termino-terminal anastomoses both of veins and arteries, with no need for vascular grafts. This means that the internal mammary vessels are dependable for microsurgical anastomoses in breast reconstruction, in discordance with international data. Pros and cons of this method are herein discussed. The authors are currently studying its applications on cadavers and results are soon to be published
