In free-flaps breast reconstruction planning, proper selection of adequate recipient vessels is crucial for a successful outcome. This study was designed to reduce the morbidity and to seek alternative recipient vessels. The clinical experience with internal mammary perforator branches (IMPB) as recipient site in immediate and late reconstructions, enabled the authors to describe the main parameters and prevalence of the vessels in immediate and late breast reconstructions. In the clinical study 40 patients underwent 42 deep inferior epigastric perforator (DIEP) flap and 02 superior gluteal artery perforator (S-GAP) flap breast reconstructions with 28 immediate and 4 bilateral. The receptor vessels were evaluated. 14 (46,6%) successful anastomoses were performed at the IMPBs (2° ICS and 3° ICS) with 13 DIEP and 1 S-GAP. All surgeries were performed as immediate reconstructions. One case of immediate vein thrombosis, one case of late arterial thrombosis and one of pedicle avulsion during flap molding were observed. This study demonstrated that the IMPB as a recipient site is a further refinement to free flap breast reconstruction. However, it is neither a reproducible technique nor potentially applicable in all patients. Preoperative planning between the general and plastic surgeon is crucial in order to preserve the main perforator branches during mastectomy. The procedure was not demonstrable in late reconstructions. The main advantages of IMPBs used as recipient site are sparing the internal mammary vessels for a possible future cardiac surgery, prevention of thoracic deformities and decreasing operative time by limited dissection.