Immediate Breast Reconstruction with Stacked Diep Flap

Introduction: The aim in this case is the immediate breast reconstruction with Stacked DIEP flap after reduction pattern mastectomy with high breast volume and low volume in donor area.

Methodology and Material: The stacked DIEP flap should be an option in patients requiring breast reconstruction and do not have a sufficient volume of abdominal fat to reconstruct the breast volume needed. Before the surgery an angioTAC was done to visualize perforating arteries. The surgery started making conventional DIEP flap dissection, once the deep inferior epigastric unilateral pedicle is dissected the dissection of the contralateral pedicle is done. After we made the autonomization of the flap, second pedicle is anastomosed to a branch of first and then the first pedicle to the internal mammary artery. Thus good perfusion of the entire flap is achieved and this allows us not to discard IV zone and use the entire volume of the DIEP flap.

Results: Postoperative course of the patient was favorable without immediate or late complications, with a satisfactory breast volume and an acceptable cosmetic result. Following the adjuvant treatment retouching the flap and contralateral reduction mammaplasty will be made.

Conclusions: We believe that stacked DIEP flap is a good option in patients requiring breast reconstruction with considerable breast volume and low volume in donor site.