Before and after bilateral delayed reconstruction in a 59 year old woman. She had undergone non-skin sparing mastectomies several years ago and was never offered breast reconstruction. At one of our Breast Reconstruction Awareness (BRA) Day community events, she learned she had options!
She was missing chest wall skin but she had previously had a tummy tuck, so a DIEP flap was not an option. She had some excess inner thigh skin and fat, so a TUG flap was her next best option.
Bilateral TUG flaps were planned. Her eventual goal was to be reconstructed similar to her original breast size, which was a full and perky DD cup. The plan was to microsurgically transplant healthy skin and fat from her inner thighs to her chest and to augment the flaps at a second stage procedure using implants.
Her right TUG flap healed well, but her left TUG flap had circulatory problems and did not heal well. This is a very uncommon complication of microsurgery, which is more common after significant radiation damage to the chest wall, or occasionally, bad luck. The flap had to be taken away and another reconstruction option considered a year later after all the surgical swelling had resolved.
She had abundant extra skin and fat on her back – a latissimus dorsi (LD) skin and muscle flap was her next best option for the left side. An LD flap was planned together with placement of implants under both flaps as a secondary procedure. The latissimus flap healed well without problems.
Follow up photos are shown 3 years after the right TUG flap breast reconstruction and a year and a half after the left sided LD flap and bilateral augmentations. She is planning bilateral nipple and areola reconstructions and possible fat grafting as a final procedure.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
