Before and after left delayed DIEP flap breast reconstruction in a 50 year old woman. She had previously had a left mastectomy without reconstruction for breast cancer. She had recently completed chemotherapy and did not need radiation.
She was offered a latissimus dorsi flap for reconstruction but she was left handed and did not want to lose her back muscle on her dominant side. She was an appropriate candidate for the DIEP flap. Her right breast was oversized and extremely droopy, with Grade III ptosis (nipples pointing to the ground). She wished to undergo a right prophylactic mastectomy and use her tummy tissue to reconstruct both breasts.
Bilateral DIEP flaps were used to reconstruct her breasts. A lift was incorporated into her right breast reconstruction. Her right nipple and areola was saved and reapplied to her right breast skin as a free nipple-areola complex graft. Her left breast required a skin paddle to be showing to replace missing tissue after her mastectomy.
Follow up photos are shown at 3 months after surgery. She still has swelling of both breast reconstructions and her abdomen. This firm swelling (called edema) will gradually resorb over the next 6 to 9 months. She will have a left nipple and areola reconstruction with tattoo of the right areola as well for the very best symmetry. She is also a candidate for some free fat grafting at her second stage procedure, which is usually at 6-12 months after a DIEP flap.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
