Before and after delayed DIEP flap breast reconstruction in a 59 year old woman. She had previously had a mastectomy followed by chemotherapy in another state, and a breast reduction several years ago.
In her home state she was only offered an implant for reconstruction or procedures that sacrificed major muscles from her abdomen or back; these options were unattractive to her. What she despised the most was her “awful, ugly cleavage” due to loss of soft tissue padding in the left upper chest area when she leaned forward (this is never corrected by an external breast prosthesis!).
She did her homework, and traveled to San Francisco for DIEP flap breast reconstruction. She understood that while she had a close match of lower abdominal tissue to her right natural breast, a perfect match of size and shape can never be guaranteed. She declined a small breast reduction on the right for improved symmetry with the anticipated DIEP flap volume.
Early follow up photos are shown three weeks after surgery, immediately before she returned home to continue her healing. She still has a significant amount of swelling of her abdomen, which will gradually resolve over the next 3-12 months. She may return for a nipple and areola reconstruction at one year, or she has the option of having this outpatient procedure closer to home.
She was thrilled to show off the improved cleavage in her post-surgical bra when she leans forward – her number one goal! If she wishes to increase the volume of the left breast reconstruction in the future, she is a candidate for free fat grafting to the left side at the time of nipple and areola reconstruction or placement of a small implant beneath her DIEP flap.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
