Breast Reconstruction Pathways

Stacked DIEP flap breast reconstruction is an advanced microsurgical technique that uses two flaps of your own abdominal tissue to rebuild one breast. It offers the same natural look and feel as a traditional DIEP flap — with added volume for women who need or want more fullness in their reconstruction.

This approach is often recommended for women who are thin, have limited abdominal tissue, or want to match a naturally fuller breast.

What is a Stacked DIEP Flap?

A stacked DIEP flap is a variation of the standard DIEP flap procedure.

Instead of using one section of tissue from the lower abdomen to create a breast, the surgeon uses two separate flaps and carefully layers (or “stacks”) them together to form a single reconstructed breast. Each flap is connected to its own blood supply to keep the tissue healthy and viable.

Like a standard DIEP flap, this technique:

• Uses skin and fat only — no muscle

• Preserves abdominal strength

• Creates a breast that looks, feels, and ages naturally

Who May Benefit from a Stacked DIEP Flap?

This option may be ideal if you:

• Have a slender body type with limited donor tissue

• Want a larger reconstructed breast than one flap can provide

• Need to match a fuller natural breast on the opposite side

• Have had prior abdominal surgery that limits available tissue

• Want an autologous (your-own-tissue) option instead of implants

Not everyone is a candidate — evaluation by a microsurgeon experienced in stacked flap techniques is essential.

How the Procedure Works

1. Two flaps of skin and fat are taken from the lower abdomen

2. The flaps are transferred to the chest

3. Each flap’s blood vessels are carefully connected under a microscope

4. The flaps are layered together to create one breast mound

5. The abdomen is closed similar to a tummy tuck

The result is a full, soft, natural-looking breast created entirely from your own tissue.

Benefits of Stacked DIEP Flap Reconstruction

• Creates more volume than a standard DIEP flap

• Maintains the natural feel of autologous reconstruction

• No muscle removal from the abdomen

• Long-lasting results that change naturally with your body

• Avoids the need for implants

• Can improve symmetry when matching a larger breast

Considerations to Keep in Mind

• Surgery is more complex than a standard DIEP flap

• Operative time is typically longer

• Requires a surgeon with advanced microsurgical expertise

• Not available at all reconstruction centers

• Recovery is similar to DIEP flap but may involve:

  • Slightly longer hospital stay

  • More careful early monitoring of blood flow

Recovery and Healing

Most patients stay in the hospital 3–5 days after surgery. Recovery includes:

• Gradual return to daily activities over 4–6 weeks

• Temporary abdominal tightness or swelling

• Follow-up visits to monitor healing and circulation

• Possible later revision procedures for refinement and symmetry

Many women say the trade-off is worth it for the confidence and comfort of a breast reconstructed entirely from their own tissue.

Stacked DIEP vs. Standard DIEP Flap

Is a Stacked DIEP Flap Right for You?

Every reconstruction journey is unique. The right option depends on:

• Your body type

• Your reconstruction goals

• Your medical history

• The expertise available in your area

Talking with a board-certified plastic surgeon who specializes in microsurgical breast reconstruction is the best way to explore whether a stacked DIEP flap could be part of your healing path.