Septocutaneous Tensor Fasciae Latae (sc-TFL) perforator flap for breast reconstruction: Radiological considerations and clinical series Figure 8.5. intraoperative image of perforator running through the dorsal septum of the tensor fasciae latae muscle. Blunt dissection of the perforator in the septal plane between TFL and gluteus medius muscle is usually straightforward. Musculocutaneous branches to the TFL and to the gluteus medius muscle were carefully ligated. The dissection proceeds in a retrograde way (directed from superficial to deep) underneath the vastus lateralis muscle to the origin of the ascending branch of the LFCA. Flexion and extension of the leg (giving more and less tension on the TFL respectively) and the aid of a light hook are essential. Usually the dissection was stopped at the origin of the ascending branch of the LCFA. In one case a perforator running between the TFL and the rectus femoris-vastus lateralis muscles (ventral septum of the TFL) was chosen (fig 8.3). 138
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