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Tang et al. Plast Aesthet Res 2024;11:61 Plastic and
DOI: 10.20517/2347-9264.2024.117
Aesthetic Research

Review Open Access

Autologous augmentation of contralateral native
breast in conjunction with unilateral abdominal-

based free flap breast reconstruction: case series
and literature review

Sherry Y. Q. Tang, Theodore A. Kung, Adeyiza O. Momoh

Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI 48109-5340, USA.
Correspondence to: Dr. Adeyiza O. Momoh, Section of Plastic Surgery, Department of Surgery, University of Michigan, 1500 E.
Medical Center Drive, 2130 Taubman Center, Ann Arbor, MI 48109-5340, USA. E-mail: amomoh@med.umich.edu

How to cite this article: Tang SYQ, Kung TA, Momoh AO. Autologous augmentation of contralateral native breast in conjunction
with unilateral abdominal-based free flap breast reconstruction: case series and literature review. Plast Aesthet Res 2024;11:61.
https://dx.doi.org/10.20517/2347-9264.2024.117

Received: 30 Aug 2024 First Decision: 31 Oct 2024 Revised: 12 Dec 2024 Accepted: 23 Dec 2024 Published: 31 Dec 2024
Academic Editors: Christodoulos Kaoutzanis, Warren Matthew Rozen Copy Editor: Ting-Ting Hu Production Editor: Ting-Ting
Hu

Abstract
In autologous breast reconstruction, the deep inferior epigastric perforator (DIEP) flap is the most commonly used.
For patients undergoing unilateral breast reconstruction who desire augmentation of the contralateral breast but
wish to avoid using implants, augmentation of the contralateral breast using DIEP flaps is a reliable option.
Preoperative evaluation requires assessing the patient’s desired outcome and the amount of abdominal tissue
available. CT angiography (CTA) helps facilitate the evaluation of abdominal perforator anatomy and the
estimation of flap volumes for simultaneous reconstruction and contralateral augmentation. Flap design takes into
consideration the perforators needed for a large flap for the primary reconstruction and the length of the pedicle
needed to access contralateral recipient vessels for a smaller flap for augmentation. One set of recipient vessels
[internal mammary artery (IMA)/internal mammary vein (IMV)] are used with antegrade anastomoses performed
for primary reconstruction flaps and retrograde anastomoses for flaps used in augmentation. Augmentation flaps
can be completely buried or include a skin paddle for monitoring. Subsequent secondary procedures are often
needed to achieve the desired final breast shape and symmetry. Overall, patients who have undergone unilateral
autologous breast reconstruction with simultaneous contralateral autologous augmentation report high levels of
satisfaction postoperatively.

Keywords: Breast reconstruction, autologous augmentation, DIEP

© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
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