Patient 149 Gallery

Before and after right non-nipple-sparing mastectomy and immediate DIEP flap breast reconstruction in a 48-year-old woman with right breast cancer. She did not want an implant for reconstruction, was thrilled that she could use her own tissue as a free flap for reconstruction, and did not want any surgery on her left breast.

A combined right skin-sparing mastectomy and deep inferior epigastric artery perforator flap was performed, with the goal to have the right breast reconstruction best match the left. Unfortunately, the patient had loss of some skin due to the mastectomy skin flaps being made very thin, and she required wound packing for several months. The last photo below shows the interim deformity prior to final reconstruction revision.

Following eventual wound healing and scar maturation, the patient was ready for a right breast reconstruction revision and right nipple-areolar reconstruction. A piece of the left nipple was moved to the right as a free nipple graft (“nipple sharing”), and medical tattoo created a new areolar circle. Her left areola was also tattooed for symmetry of the color, hue and intensity of the areolar color.

Follow up photos are shown 2 years after her mastectomy and 6 months after her revision procedure. She required another surgical procedure a few months ago, resulting in a new lower abdominal scar. She feels ready to resume all her normal activities and, despite her wound healing issues and need for a secondary revision (which is more often the norm than the exception), she is pleased with her DIEP flap breast reconstruction outcome!