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to the large difference in diameters, the SIEA and the IMA at the 2nd intercostal level might need to adopt an end-to-side anastomosis or switch to the TDA recipient site. Based on this study's findings and aesthetic effect considerations, we think that the 3rd and the 4th intercostal planes are ideal choices for the end-to-end anastomosis. As a salvage recipient option, the TDA can theoretically achieve an end-to-end anastomosis with the SIEA at a value of BMI ≥ 24g/m . This journal requires that authors assign a level of evidence to