You will need to open the image with one ID as you are doing now.
When you scan, you will need to scan it to a new temporary ID.
Imaging1.TwainAcquireToGdPictureImage
_nImageID = Imaging1.GetNativeImage
Then after the scan put the two together with
Imaging1.TiffAppendPageFromGdPictureImage(nTiffOriginal, _nImageID)
When done scanning, need to make sure you close the temporary ID image.
Imaging1.CloseImage(_nImageID)
Set the oringinal Id as the native image.
Imaging1.SetNativeImage(nTiffOriginal)
Then save the image as you did the first time.
There are examples on the web that go over this, though sometimes you have to piece stuff together from more than one example.
This will append new scans to the end of an existing tiff.
If you want to get fancy and insert into the beginning or middle, you will have to to this same process and then reorder the pages after the append is done.
For more info on opening /saving the tiff, see the post from Tom M. here
howto-save-modified-tiff-file-t1047.html
Mike S.
GdPicturePro.Net v6.2.14
GdPicturePro5 v5.8.0
Vb.Net /Visual Studio 2005