Sequential bilateral breast reconstruction using a split solitary deep inferior epigastric artery perforator flap

Autogenous tissue bilateral breast reconstruction often requires microsurgical tissue transfers. The reality is that sometimes revascularization cannot be accomplished, leading to a total flap failure. If one flap survives, another attempt using a second flap is necessary to achieve symmetry. Nonmicrosurgical options to achieve this are limited. If the successful flap is bulky enough, it can be bisected to create a local island flap based on the original flap pedicle to allow completion of the contralateral reconstruction. This concept is here presented using a split deep inferior epigastric artery perforator flap for sequential bilateral breast reconstruction.