Background: Breast cancer management is often associated with significant prevalence of upper extremity lymphedema, which when it occurs can be devastating. The patient needs to be shielded from this unpleasant experience, and to prophylactically treat the occurrence, there are various named surgical physiological options available. Candidates for these remedies, however, often also present the need for breast reconstruction.

Case Report: We offered a prophylactic vascularized inguinal lymph node transfer (VILNT) for lymphedema prophylaxis in combination with a deep inferior epigastric artery perforator (DIEP) chimeric flap for breast reconstruction.

Patient: A 50-year-old female requiring delayed breast reconstruction presented with a right-side mastectomy scar and a history of ipsilateral axillary dissection performed a year earlier, followed by adjuvant chemotherapy.

Outcome: We performed a free chimeric DIEP and VILN transfer with good results.