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Hemiabdominal Deep Inferior Epigastric Perforator Flap Banking for Contralateral Occult Breast Cancer
Chikano Amei1, Toshihiko Satake1,2, Kokoro Kamisaka1
1From the Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, University of Toyama, Toyama, Toyama, Japan.
Plastic and Reconstructive Surgery. Global Open
|March 20, 2026
Summary
This study introduces a novel hemi-deep inferior epigastric perforator (DIEP) flap technique for breast reconstruction. It preserves the unused flap for future contralateral reconstruction, reducing donor site morbidity and improving symmetry.
Area of Science:
- Plastic Surgery
- Oncology
- Reconstructive Surgery
Background:
- The deep inferior epigastric perforator (DIEP) flap is the standard for autologous breast reconstruction.
- Abdominal tissue availability limits its use for metachronous contralateral breast cancer reconstruction, causing symmetry and scarring concerns.
Purpose of the Study:
- To present a modified hemi-DIEP flap technique for initial breast reconstruction.
- To preserve the unused hemi-flap subcutaneously for potential future contralateral breast reconstruction.
Main Methods:
- A 69-year-old woman with right breast cancer underwent nipple-sparing mastectomy and immediate reconstruction with a hemi-DIEP flap.
- The contralateral hemi-DIEP flap was denuded and stored subcutaneously in the lower abdomen.
Main Results:
- The abdominal donor site healed well with minimal scarring and no cosmetic deformity.
- The preserved hemi-flap remains available for future use, maintaining tissue quality.
Conclusions:
- This hemi-DIEP flap approach offers a viable solution for patients at high risk of contralateral breast cancer.
- It minimizes donor-site morbidity and ensures optimal symmetry and tissue availability for future reconstructive needs.
