Before and after bilateral DIEP flap breast reconstructions in a 46 year old woman. She previously had a left non-skin sparing mastectomy and tissue reconstruction and a reduction of the right breast. Her left expander was contracted and too small for her breast “footprint”, as its width was too narrow and its volume too small when compared to the other side.
She wished to have a prophylactic mastectomy on the right side and bilateral reconstruction using her own tissue. She was an ideal candidate for the DIEP flap, given her “failed” (unsatisfactory) implant reconstruction, her unwanted excess abdominal tissue and goal for a solution that would allow her to move forward and have a “Mommy Makeover” at the same time!
A right nipple sparing mastectomy was done and the left implant was removed. Her left pectoralis major muscle was returned to the chest wall and the original boundaries of her left breast were opened up again to accept the abdominal tissue to match her right breast.
Bilateral DIEP flaps were microsurgically transplanted from her lower abdomen to the chest. An immediate nipple reconstruction was performed on the left by the “nipple sharing” technique, taking a piece of the right nipple and moving it to the left side via a free nipple graft. Tattoo of the areolas was done immediately on both sides for the very best symmetry.
Early follow up photos are shown one month after surgery. It is unlikely that she will need any additional surgery. However, second satge free fat grafting is always discussed as an option in the future, which enables women to decide where excess fat will be harvested from! (i.e. automatic liposuction – who would say no to that?!).
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
