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Bilateral Breast Reconstruction from a Single Hemiabdomen Using Angiosome-Based Flap Design

Smith, Mark L. M.D.; Gandolfi, Brad M. M.D.; Dayan, Erez M.D.; Clarke-Pearson, Emily M. M.D.; Samson, William M.D.; Sultan, Mark R. M.D.; Dayan, Joseph H. M.D.

Plastic and Reconstructive Surgery: August 2013 - Volume 132 - Issue 2 - p 291–294
doi: 10.1097/PRS.0b013e31829587ca
Breast: Ideas and Innovations

Summary: Performing bilateral autologous breast reconstruction using the abdominal donor site usually entails harvesting one flap from each hemiabdomen. However, the overlapping vascular territories of the superior epigastric, deep inferior epigastric, superficial inferior epigastric, and superficial circumflex iliac vessels make it theoretically possible to harvest two flaps based on vessels from one hemiabdomen. This may be useful in the obese patient, where one hemiabdomen may provide adequate tissue to reconstruct two breasts. The authors describe three clinical scenarios where they have used this principle, including the first reports in the literature of metachronous and synchronous bilateral breast reconstructions using two flaps based on pedicles from a single hemiabdomen.


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New York, N.Y.

From the Division of Plastic and Reconstructive Surgery and the Department of Surgery, Beth Israel Medical Center; and the Division of Plastic and Reconstructive Surgery, St. Luke’s-Roosevelt Medical Center.

Received for publication December 16, 2012; accepted February 12, 2013.

Presented at the 2012 Annual Meeting of the American Society for Reconstructive Microsurgery, in Las Vegas, Nevada, January 11 through 17, 2012.

Disclosure: The authors have no significant financial interests to disclose. No funding was received toward the completion of this article.

Supplemental digital content is available for this article. Direct URL citations appear in the text; simply type the URL address into any Web browser to access this content. Clickable links to the material are provided in the HTML text of this article on the Journal’s Web site (

Mark L. Smith, M.D. Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Medical Center, 10 Union Square East, Suite 2L New York, N.Y. 10003

©2013American Society of Plastic Surgeons