Modern Approaches to Alternative Flap-Based Breast Reconstruction: Stacked Flaps.

Total breast reconstruction following mastectomy requires multiple components to achieve an aesthetic result. In some situations, significant skin is required to provide the needed surface area to allow breast projection and breast ptosis. Additionally, ample volume is required to reconstruct all breast quadrants and provide sufficient projection. All aspects of the breast base must be filled to achieve total breast reconstruction. In very specific circumstances, multiple flaps are employed to accomplish this level of uncompromised aesthetic breast reconstruction. The abdomen, thigh, lumbar region, and buttock can all be used in some combination, as needed, to perform both unilateral and bilateral breast reconstruction. The ultimate goal is to provide superior aesthetic results in both the recipient breast and the donor site while maintaining a very low level of long-term morbidity.