The Rubens flap. The deep circumflex iliac artery flap.

The Rubens free flap for breast reconstruction is another choice for autogenous tissue breast reconstruction. It uses the fatty area in the region generally described as the hip overlying or just above the iliac crest. It is based on the deep circumflex iliac artery and is indicated as a secondary choice in the presence of a previous abdominoplasty or transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction. Closure of the abdominal wall musculature along the iliac crest is the most exacting portion of this operation and is a key to its ultimate success.