Contralateral Breast Augmentation With DIEP Flap During Unilateral Oncologic Breast Cancer Reconstruction Utilizing Single-Site Antegrade and Retrograde Vascular Anastomosis: A Case Report

Document Type

Conference Proceeding

Publication Date

9-2026

Publication Title

Plastic and Reconstructive Surgery. Global Open

Abstract

Problems Addressed: The deep inferior epigastric perforator (DIEP) flap is considered the gold standard in autologous breast reconstruction. In women with bilateral breast cancer undergoing reconstruction, both flaps are often anastomosed to the internal mammary vessels on either side of the sternum. DIEP flaps are widely used for reconstructive purposes; however, their use for cosmetic augmentation is less common. The use of a single-site recipient internal mammary vessels is not standard of care, and there are no studies describing the use of both the antegrade and retrograde right internal mammary artery as recipient vessels for bilateral DIEP flaps. This case report demonstrates the use of bilateral differentially split DIEP flaps for contralateral breast augmentation in unilateral breast cancer reconstruction using the right internal mammary artery (IMA) as the recipient for both flaps in antegrade and retrograde fashion. Techniques: We describe a case of breast reconstruction after unilateral breast cancer with contralateral cosmetic breast augmentation using DIEP flaps using single site anastomosis with the right IMA as the recipient for both flaps in antegrade and retrograde fashion. A subcutaneous tunnel was created over the sternum to allow for the left DIEP pedicle to enter the right chest. The antegrade and retrograde IMA was used to connect the right and left DIEP flaps, respectively. Outcomes: Both flaps survived and healed without any post operative complications. At 6 months, the patient exhibited well-perfused, soft, and symmetric natural appearing breasts with high satisfaction and quality of life scores at post op follow-up. Conclusions: In select patients with unilateral breast cancer seeking symmetric natural appearing breasts without the use of prosthetics, with adequate abdominal tissue and favorable vascular anatomy, unilateral reconstruction with contralateral augmentation with bilateral differentially split DIEP flaps utilizing single chest recipient vessels in antegrade and retrograde fashion may be feasible.

Volume

14

Issue

S4

First Page

9

Last Page

10

Comments

Michigan Academy of Plastic Surgeons Annual Meeting, July 12-15, 2026, Mackinac Island, MI

DOI

10.1097/01.GOX.0001276708.91448.22

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