Before and after DIEP flap breast reconstruction in a 41 year old woman with left breast cancer. She previously had a left lumpectomy but her margins were positive. She needed a completion mastectomy with removal of her left nipple and areola complex. She was a candidate for either an implant or a flap; she chose the deep inferior epigastric artery perforator (DIEP) flap.
Although she had not had children, she viewed this surgery as her “breast cancer makeover” (like a Mommy Makeover)! Her aesthetic goals were to have better symmetry and a more youthful breast shape that better matched her early-40s body. A breast lift was planned on the right side.
A skin sparing mastectomy, left DIEP flap breast reconstruction and right mastopexy was performed as a combined procedure. A small skin paddle was left in the location of the old areola on the left. A free nipple graft was taken from the right nipple and transplanted to the left breast reconstruction as an immediate nipple reconstruction. This is called “nipple sharing”.
Six months later, she underwent bilateral areola tattoo. This filled in the skin paddle on the left and made her right areola a similar color intensity and hue. Free fat grafting (also called “lipofilling”) further benefitted her abdominal donor site and contoured her upper and lower abdomen, hips, thighs and axillary rolls (back fat/bra rolls). Note the improved appearance of the sides of her breasts before and after surgery!
Follow up photos are shown one year after her DIEP flap breast reconstruction and six months after her second stage outpatient surgery.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
