This is a case of a 58-year old female who presents for bilateral perforator flap breast reconstruction after developing capsular contracture from prior radiation to the right breast. The patient underwent bilateral DIEP flap reconstruction that was complicated by insufficient left internal mammary vessels that was discovered once the flap was under ischemia time. The current case demonstrates a safe and viable alternative option that allows efficient and effective reconstructive success while minimizing ischemia time.
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