Before and after revision of a breast reconstruction by replacement of a submuscular implant with a DIEP flap. This 58 year old woman previously had a right mastectomy and reconstruction with a submuscular tissue expander and implant reconstruction. She had a previous attempt at right nipple reconstruction, but it was placed too low and too lateral (off to the side).
Her right breast implant was displaced upward and was tight and painful, due to chronic pectoralis major muscle contraction. She considered having her implant removed and having no reconstruction at all, but then she learned about the DIEP flap!
She loved the idea of using her own tissue to reconstruct her breast. On the left side, she had a contracted implant with droop of her left nipple and areola off the implant. She wanted both implants out and to only have her own tissue; she did not mind being slightly smaller!
Both implants were removed, and her pectoralis muscles were returned to her chest wall. A DIEP flap reconstructed the right breast. A mastopexy (breast lift) reshaped the left breast and lifted her nipple. A free nipple graft from the left side reconstructed her right nipple, and medical tattoo was performed bilaterally for the very best symmetry.
Follow up photos are shown one year after her DIEP flap and three months after right nipple and areola reconstruction.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
