Purpose: Plastic surgery has been a pioneer in a field that has not only dealt with tissue rearrangement but tissue transfer. The first successful kidney transplantation occurred from one identical twin to another in 1954 by a plastic surgeon: Dr. Joseph E. Murray. Since then, transplantation has become an evolving field and the future of surgery. We present three cases of deep inferior epigastric perforator flaps (DIEP) and superior inferior epigastric perforator flap (SIEA) in identical twins used to create breast from patients who underwent mastectomies from breast cancer.
Methods: Three sets of recipient monozygotic twins were diagnosed with breast cancer and underwent mastectomies from 2000 to 2006 were reconstructed using DIEP/SIEA. Each set of twins underwent extensive HLA stereotyping to determine if they were genetically monozygotic. This was established to avoid possible rejection and the need for immunosuppressive therapy.
Results: Two identical twin recipients underwent unilateral breast reconstruction with the SIEA and DIEP and the third identical twin recipient underwent bilateral breast reconstruction using the DIEP. Their hospital course were unremarkable and the donor twins were discharged on post-operative day one while the recipient twins were discharged on post-operative day four without any complications.
Conclusion: Transplantation is the key to the future in surgery. We present the first ever three cases of identical twins, two twins with unilateral and one twin with bilateral breast reconstruction using the SIEA and DIEP. This procedure offers another option for breast reconstruction in women who may not have the necessary tissue for breast reconstruction in identical twins.