What Is A Stacked DIEP Flap?
By: Courtney Floyd
DIEP flap breast reconstruction uses the patient’s lower tummy tissue to reconstruct a breast after mastectomy. Unlike the TRAM, the DIEP does not use any abdominal muscles. Only skin and fat are used.
Many patients have enough lower abdominal tissue to reconstruct both breasts if desired. However, even thin patients who don't have a lot of lower tummy tissue can be DIEP flap candidates - in these cases, all the lower abdominal tissue can be used to reconstruct one breast.
Which patients can benefit from a stacked DIEP?
In some situations, the required amount of lower tummy tissue to reconstruct the breast cannot be transplanted to the chest as a single flap. For example, the patient may have a midline abdominal scar from previous surgery, or may be too thin. In these cases, the lower abdominal tissue can be transplanted as 2 separate flaps which are then reconnected on the chest using microsurgery to create one breast. The flaps are stacked, or folded, to create the required breast shape and volume. This technique is known as the stacked DIEP flap procedure.
Dr. Garza explains how we perform this procedure in more detail here:
Some patients need both breasts reconstructed but are not candidates for bilateral DIEP flaps. In these cases, tissue from another area of the body can used for the opposite breast, or a combination of flaps can be used for each breast.
Other tissue reconstruction options include: