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Patients with recurrent breast sarcoma on chest wall often receive radical surgical resection that result in large skin & soft tissue defects. These changes demand flap coverage for chest wall stability and durable soft tissue coverage. We introduce a case with recurrent breast sarcoma on chest wall which resulted in huge chest wall defect that was successfully covered with free bilateral deep inferior epigastric perforator (DIEP) flap coverage. A debulking operation was planned for recurrent tumor mass found on the chest wall of a 47-year-old female who received simple mastectomy for left breast sarcoma. A cardiothoracic surgeon conducted en bloc chest wall resection with 2nd to 5th rib resection. The size of the defect was measured as 25 cm×22 cm and free bilateral DIEP flap was conducted for the coverage. Robust flap was seen at two month follow-up and no donor site complication occurred. Bilateral DIEP flap provides enhanced vascular perfusion, allowing for harvest of larger volumes of tissue. When the chest wall defect requires huge volume to cover, bilateral DIEP flap would be a valuable option as it provides substantial volume of durable tissue offering optimal aesthetic outcome and minimal donor site morbidity.

Reconstruction of a Large Chest Wall Defect with Free Bilateral Deep Inferior Epigastric Perforator Flap