This patient was diagnosed with tumors in both breasts, for which she desired bilateral mastectomy and immediate reconstruction. She wished to used her abdominal tissue and retain her native breast volume. Often, a DIEP flap alone will not provide enough healthy tissue to create one breast. In this case, additional blood supply can be added to the DIEP flap to augment the blood supply to carry enough tissue to create a large breast. In this case, the superficial inferior epigastric artery (SIEA) was added for additional blood supply. This decreases the chance of fat necrosis or other complications of carrying a large volume of tissue on only blood vessel. These vessels are each dissected through the muscle, preserving muscle, fascia, and nerves.
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