Before and after delayed left DIEP flap breast reconstruction in a 46 year old breast cancer survivor. She had previously undergone left mastectomy and implant reconstruction which failed due to infection and required removal. She had chemotherapy and radiation therapy and was over one year from the end of her left chest wall radiation. She required new, healthy soft tissue to be transplanted to her left chest for breast reconstruction.
A DIEP flap reconstruction was performed on the left side. She had an overabundance of abdominal skin and fat, which was also excised and discarded. She did not wish to have a prophylactic mastectomy on the other side. She tested negative for the BRCA gene. A right sided balancing reduction mammoplasty gave her a more proportional breast and a lift on the other side.
Follow up images are seen at 2 months postoperatively. Radiation effects can still be seen (darker pigmentation in the radiation field and “peau d’orange” (skin of the orange, in French, or firm dimpling of the skin) from swelling). This edema will gradually resolve over months.
She will be offered additional contouring of the sides of her chest and abdomen with liposuction in the future and medical tattoo to her faded left sided nipple and areola graft that was preserved.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
