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Before and after bilateral prophylactic nipple-sparing mastectomies and combined DIEP flap and sub-flap implant breast reconstruction in a 31-year-old woman who was a carrier for the BRCA gene. She had submuscular implants before surgery, and her goal was for her reconstructed breasts to have the same size and projection as her augmented breasts.

A two-stage surgery was planned. At her first procedure, combined mastectomies that preserved her nipples, removal of her breast implants and bilateral microsurgical breast reconstruction was performed. Six months later, implants were placed under her flaps but on top of her chest muscles.

Follow up photos are shown one year after mastectomies and DIEP flaps and 6 months after implant reconstruction surgery.

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*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.

Dr Karen Horton