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Related Experiment Video

Updated: Apr 14, 2026

An Experimental Human DIEP Flap Model to Investigate Preservation Strategies for Vascularized Composite Allografts and Free Flaps

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Published on: December 5, 2025

Bipedicle-conjoined perforator flaps in breast reconstruction.

Pieter G L Koolen¹, Bernard T Lee¹, Samuel J Lin¹

¹Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

The Journal of Surgical Research

|April 29, 2015

Summary

Bipedicle-conjoined abdominal perforator flaps offer a reliable solution for autologous breast reconstruction when insufficient tissue is available. This novel technique provides increased skin and volume for aesthetically satisfactory results.

Keywords:

Bipedicle DIEP flap Breast cancer Breast reconstruction Deep inferior epigastric perforator flap Stacked DIEP flap

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Area of Science:

Plastic Surgery
Reconstructive Surgery
Microsurgery

Background:

Autologous breast reconstruction can be challenging due to insufficient abdominal skin and soft tissue.
Single-pedicle deep inferior epigastric perforator artery flaps have variable perfusion, limiting reconstructive options.

Purpose of the Study:

To examine the experience and outcomes of using bipedicle-conjoined abdominal perforator flaps for breast reconstruction in patients with limited tissue availability.

Main Methods:

A retrospective review of 28 patients undergoing bipedicle-conjoined abdominal perforator flap reconstruction over a 2-year period.
Flap pedicles were anastomosed to internal mammary artery vessels or branches.

Main Results:

No flap losses occurred; one case of fat necrosis (3.2%) was reported.
The technique provided a large, contiguous skin island, enabling extensive tissue replacement.
Aesthetically satisfactory results were achieved in all patients.

Conclusions:

Bipedicle-conjoined abdominal perforator flaps are a safe and reliable novel technique for select breast reconstruction patients.
This method offers increased skin and volume compared to unipedicle flaps, enhancing flexibility for desired shape and projection.