Patient 14 Gallery

Before and after bilateral breast reconstruction with a DIEP flap and a later TUG flap after breast cancer diagnoses one year apart.  This 52 year old woman had a right breast cancer treated with a non-skin sparing mastectomy, chemotherapy and radiation therapy. 

A submuscular tissue expander and implant reconstruction was performed elsewhere.  She did not like the tight implant and constriction of her pectoralis major muscle.  She wanted to convert her implant reconstruction to an “autogenous tissue” reconstruction (using the body’s own tissue, also known as a “flap”). 

Her right implant was removed, her pectoralis muscle was returned to the chest wall and repaired, and a DIEP flap reconstructed the right breast.  Much of her right chest radiated skin was replaced with healthy skin from the DIEP flap. 

She recovered well from this procedure.  Unfortunately, one year later she had a left sided breast cancer.  By now, she preferred flap reconstructions to implants.  Since her abdominal tissue had already been used, we turned to her inner thighs.  She was a candidate for a left nipple sparing mastectomy. 

Her right inner thigh was used as a TUG flap to reconstruct her left breast.   Six months after this procedure, she underwent right nipple reconstruction using the “nipple sharing” technique where a piece of the left nipple saved in her nipple sparing mastectomy was moved to the right breast reconstruction as a free nipple graft. 

Bilateral and areola reconstruction involved tattoo to both sides to ensure symmetry of color, hue and intensity.  Free fat grafting to even out her inner thighs added volume to her flaps and contoured her body during this last procedure as well.  Fat was harvested from her upper and lower abdomen, flanks, upper inner thighs, outer thighs and axillary rolls. 

Follow up photos are shown 3 months after her final procedure.  She can now move on, cancer-free, without implants and with an improved figure!