Before and after left delayed DIEP flap reconstruction and right balancing augmentation-mastopexy (breast implant and lift) in a 39 year old breast cancer survivor. She had completed her left mastectomy, chemotherapy and radiation therapy a year before. Breast reconstruction was never offered to her!
Given her lack of breast skin and history of radiation, an autogenous tissue (flap) reconstruction was recommended for her. Thankfully, after having two children, she had enough lower abdominal skin and fat to reconstruct one breast. Her goal was to be fuller than her natural right breast. A large DIEP flap was planned on the left, and an implant with a breast lift on the right.
Skin and fat from her belly was microvascularly transplanted to the chest on the deep inferior epigastric artery perforating blood vessel (DIEP) and its veins, sewing them together under the operating microscope to the internal mammary artery and two different veins in the chest. By performing two venous anastomoses, there are two different blood outflow sources from the flap, providing extra security for uneventful flap circulation and healing.
A breast lift created symmetry to the breasts. After surgery, she got more fit and lost weight, but she maintained good symmetry of her flap reconstruction and her other breast. The “nipple sharing” technique moved some nipple tissue from her left breast to the right DIEP flap, and medical tattoo bilaterally created symmetric areolar circles.
Follow up photos are shown three and a half years after her DIEP flap with mature scars and good breast symmetry.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
