Double Stack or Bipedicled DIEP Flap

I have been pleased with the results of reconstruction of one side of a woman's breast using the entire lower abdomen. Initially five years ago when I began using the DIEP Flap for breast reconstruction I would only use half of the abdomen for the breast reconstruction and preserve the other portion during the procedure only to remove it and discard it at the end. I began to have more and more women with less abdominal tissue who really desired the DIEP Flap. I have found this to be an extremely rewarding operation for the patients and for me. Now I feel like I am utilizing all of the abdominal tissue even when I am reconstructing only one side for the patient. This added volume allows for a better initial result and less complicated procedures down the road to provide symmetry. Of course whenever possible and in accordance with the patients desires we try to improve symmetry problems by using the patient's own fat. This fat is harvested and separated into smaller portions then loaded back into smaller syringes and strategically placed to provide symmetry. This has become a mainstay in our use of the patient's won tissue to obtain natural results.