Objective. To analyze topographic and anatomical features of perforating blood supply of anterior abdominal wall regarding figured modeling and primary thinning of a DIEP flap.

Material and methods. We examined 30 non-fixed female corpses (age of dead 42 — 80 years). Surgical treatment of 3 patients with severe facial deformations was performed according to the proposed technique: 2 patients with facial hemiatrophy, 1 patient with deformation of parotid-masticatory region after previous rhabdomyosarcoma.

Results. Modeling and primary thinning of a pedicled DIEP flap expand the indications for its usage in reconstructive surgery of head and neck without significant donor damage and minimal functional impairment. Simultaneous modeling of a primary thin flap with a large surface area makes it possible to eliminate complex defects of head and neck with clear visualization plane. The technique of harvesting of primary thin DIEP flap with mean thickness of 0.9±0.09 cm was developed and applied in practice. The following parameters were established: length coefficient and perforator deviation coefficient.

Keywords. perforating vessel, flap thinning, DIEP flap, revascularization