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PURPOSE: Autologous breast reconstruction is challenging in thin patients who present for bilateral breast reconstruction. The Stacked Hemi-abdominal Extended Perforator (SHAEP) flap has been shown to increase the volume of useable abdominal tissue by adding a secondary, more lateral pedicle to the DIEP. We present a novel approach to obtaining even more volume by adding another pedicle to the SHAEP. This is the first description of the Tripedicled Extended Abdominal Perforator (TEAP) flap that allows for use of the entire circumference of the lower trunk by adding two additional pedicles to the DIEP.

Abstract: Northwell Health Patient Perioperative Pathway (P3): Enhanced Recovery Protocol for Microsurgical Breast Reconstruction