Restorative Techniques

Stacked DIEP Flap

Stacked Deep Inferior Epigastric Perforator Flap

The stacked-DIEP flap procedure uses two DIEP flaps—one DIEP flap from each side of the abdomen—to reconstruct a breast of a larger size than could be reconstructed with a single DIEP flap. (A) The blood vessels that supply each individual DIEP flap are meticulously separated from the abdominal muscle, leaving the muscle intact. (Inset) Connecting the blood vessels of each individual flap to each other creates the stacked-DIEP flap. (B) The stacked-DIEP flap is transferred to the chest and, using microsurgical techniques, connected to blood vessels at the recipient site. © The horizontal abdominal scar that results following stacked-DIEP flap surgery is similar to that created by a “tummy tuck”; the scar that results on the breast itself will depend on the technique used for the mastectomy. Many women choose to have nipple reconstruction, along with tattooing of the nipple and areola, to have a reconstructed breast that looks as realistic as possible.

Stacked-DIEP Flap is an innovative approach for women who thought they are too thin to have a breast reconstructed using their abdominal tissue

The Stacked-DIEP flap, also called a double DIEP, allows a breast to be reconstructed with significantly more tissue than can be obtained with either a single DIEP flap or a TRAM flap. This sophisticated microsurgical procedure can be an option, for example, for a thin woman who needs reconstruction of only one breast. Women who have been told that they are not candidates for a TRAM flap or a DIEP flap because they “do not have enough tissue” or because they have a vertical midline scar may be candidates for a stacked-DIEP flap reconstruction.

The Stacked-DIEP flap procedure uses two DIEP flaps (one DIEP flap from each side of the abdomen) to reconstruct a single breast. As is the case for all perforator flaps used in breast reconstruction, no muscle is sacrificed with this procedure. After the tissue is transferred to the chest, the blood vessels that supply the tissue of each of the flaps are connected to vessels at the recipient site using microsurgical techniques. The two flaps are then “stacked” and sculpted to restore the breast removed by mastectomy. Recovery is the same as it would be for any abdominal perforator flap.

Stacked DIEP Flap Breast Reconstruction in New York and Connecticut

Contact us if you would like more information about the options for breast reconstruction after mastectomy or to schedule a consultation. Our practice has offices in New York City and Greenwich, Connecticut.