Breast reconstruction is not a one-size-fits-all endeavor. Dr. Stalder and his team pride themselves on guiding you towards the procedure that’s right for your healing journey and your body. Sometimes this means recognizing that a patient will need donor tissue from more than one site (stacked flaps) for an autologous reconstruction. Others, it requires more advanced techniques to harvest the flap that will best serve the patient. Because our team is proficient in microsurgery, we’re able to offer a wide range of procedures to you. Whether you need to rebuild one breast or two, we hope you’ll familiarize yourself with the combined and advanced flap reconstruction techniques we perform.
Some patients don’t have enough tissue from one single area for autologous reconstruction. This is especially true if you’re thin. With a stacked flap approach, tissue is taken from multiple sites and “stacked” to create sufficient breast volume. We perform several different types of stacked flap procedures when necessary. Some flaps have the advantage of being bipedicle, which means a piece of tissue has a blood supply coming from both ends. This ensures the tissue our microsurgeons transfer has adequate blood flow to thrive in the breast.
Stacked DIEP
In thinner patients, a single donor area doesn’t always have enough volume and skin. But Stacked DIEP procedures solve this by using tissue from two symmetrical areas of the abdomen. This way, even thin patients can achieve a fully autologous breast reconstruction. “Stacked” refers to using multiple flaps for breast reconstruction. Stacked DIEP is only one of the many types of stacked procedures we do for our breast reconstruction patients.
DIEP + LAP
In certain patients, the lower abdomen alone can’t provide enough donor tissue. But at DIEP + LAP Flap provides a workaround, using tissue from both your abdomen and lower back. This offers greater flexibility in rebuilding a breast of the right size and shape. Using two donor sites is known as a stacked flap approach, and it’s one our team knows well.
DIEP + GAP
Similar to a DIEP + LAP Flap, the DIEP + GAP flap procedure uses two donor sites, except in this case it augments abdominal tissue with extra tissue from the buttocks. DIEP + GAP Flap a fantastic option for those who don’t have enough abdominal tissue or who want a larger breast without resorting to an implant. As a bonus, it can improve the contour of both your abdominal and gluteal areas.
DIEP + PAP
Combining donor tissue from the inner thigh with donor tissue from the abdomen, DIEP + PAP Flap provides an excellent way to achieve the breast volume you want. The donor sites also allow this procedure to be done in a way where scarring is subtle and easily covered.
Conjoined/Bipedicle
Conjoined Flaps enable us to harvest a large, continuous piece of donor tissue for autologous reconstruction. But transplanting tissue also requires connecting it to its own blood supply. That’s where the concept of Bipedicle Flaps comes in. Bipedicle means that a piece of tissue has a blood supply coming from both ends. Effectively, Conjoined and Bipedicle Flaps allow our microsurgeons to transfer larger areas of donor tissue and ensure the tissue we transfer has adequate blood flow to thrive in the breast.