Hybrid Reconstruction Excellence: Stacked DIEP Flap and Implant Integration
By: Dr. Elsie M. Rodebeck, Dr. Frank DellaCroce, and Dr. Craig Blum
Abstract
This publication presents two successful cases of hybrid breast reconstruction using stacked Deep Inferior Epigastric Perforator (DIEP) flaps combined with silicone implants. The approach allows for total implant coverage with autologous tissue, improving projection and preventing visible rippling—particularly beneficial in lean patients or complex revision cases. Both patients achieved stable, natural results with high satisfaction.
Overview
When a single DIEP flap provides insufficient volume for unilateral reconstruction, stacking both hemi-abdominal flaps or adding an implant can optimize results. This hybrid method combines the advantages of both — natural feel and implant-based projection — offering precise shaping and reduced complications.
Case Highlights
- Case 1: A 60-year-old post-mastectomy patient with prior radiation underwent delayed hybrid reconstruction using two DIEP flaps plus a small implant (120cc). The design achieved total implant coverage and balanced symmetry.
- Case 2: A 62-year-old woman with implant complications and rippling was successfully revised using stacked DIEP flaps surrounding a smaller prepectoral implant, eliminating visible irregularities.
Why It Matters
- Provides a customizable approach for achieving natural projection in unilateral reconstructions.
- Reduces implant palpability and rippling through full tissue coverage.
- Preserves abdominal contour while maximizing reconstructive options.
- Minimizes implant size and related complications through autologous support.
Technique & Discussion
Each hybrid reconstruction incorporated an ADM-secured implant combined with overlying DIEP flaps, creating total autologous coverage. The prepectoral implant placement enhanced projection while the flaps provided softness and vascular support. The result: stable, aesthetic outcomes that merge surgical precision with natural artistry.
Surgeon Perspective
Dr. DellaCroce emphasizes that the stacked DIEP + implant hybrid expands reconstructive versatility, particularly in revision or unilateral cases where volume, projection, and contour demand fine-tuned balance. The hybrid concept reflects CRBS’s commitment to innovation in personalized, restorative breast surgery.
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Learn more about Stacked DIEP and Implant Hybrid Reconstruction
Stacked DIEP and Implant for Unilateral Breast Reconstruction
By: Dr. Elsie M. Rodebeck, Dr. Frank DellaCroce, and Dr. Craig Blum
Abstract
This publication presents two successful cases of hybrid breast reconstruction using stacked Deep Inferior Epigastric Perforator (DIEP) flaps combined with silicone implants. The approach allows for total implant coverage with autologous tissue, improving projection and preventing visible rippling—particularly beneficial in lean patients or complex revision cases. Both patients achieved stable, natural results with high satisfaction.
Overview
When a single DIEP flap provides insufficient volume for unilateral reconstruction, stacking both hemi-abdominal flaps or adding an implant can optimize results. This hybrid method combines the advantages of both — natural feel and implant-based projection — offering precise shaping and reduced complications.
Case Highlights
- Case 1: A 60-year-old post-mastectomy patient with prior radiation underwent delayed hybrid reconstruction using two DIEP flaps plus a small implant (120cc). The design achieved total implant coverage and balanced symmetry.
- Case 2: A 62-year-old woman with implant complications and rippling was successfully revised using stacked DIEP flaps surrounding a smaller prepectoral implant, eliminating visible irregularities.
Why It Matters
- Provides a customizable approach for achieving natural projection in unilateral reconstructions.
- Reduces implant palpability and rippling through full tissue coverage.
- Preserves abdominal contour while maximizing reconstructive options.
- Minimizes implant size and related complications through autologous support.
Technique & Discussion
Each hybrid reconstruction incorporated an ADM-secured implant combined with overlying DIEP flaps, creating total autologous coverage. The prepectoral implant placement enhanced projection while the flaps provided softness and vascular support. The result: stable, aesthetic outcomes that merge surgical precision with natural artistry.
Surgeon Perspective
Dr. DellaCroce emphasizes that the stacked DIEP + implant hybrid expands reconstructive versatility, particularly in revision or unilateral cases where volume, projection, and contour demand fine-tuned balance. The hybrid concept reflects CRBS’s commitment to innovation in personalized, restorative breast surgery.
Learn more about Stacked DIEP and Implant Hybrid Reconstruction