Needing a large DIEAP flap for unilateral breast reconstruction: double-pedicle flap and unipedicle flap with additional venous discharge

In selected cases a four zone-deep inferior epigastric artery perfortor (DIEAP) flap is needed for unilateral breast reconstruction. It may happen in patients with a midline scar of the abdomen or with minimal abdominal tissue, as well as in case the recipient site needs a big amount of tissue for the breast reconstruction. The purpose of this paper is to describe two options: to raise an unipedicle DIEAP flap including large size medially located perforator/s with an additional venous outflow, or to raise a double-pedicle DIEAP flap.