Before and after bilateral DIEP flap breast reconstructions with postoperative radiation to the right chest in a 55 year old woman with right breast cancer. She wished to use her own body’s fat to reconstruct her breasts. She knew she likely needed radiation therapy postoperatively and chemotherapy based on her tumor details.
When radiation is required after any type of breast reconstruction, we expect the reconstruction to shrink slightly afterwards. Therefore, the DIEP flap reconstruction is made slightly larger on the side to be radiated. Radiation will not injure a healthy flap – instead, it will cause the breast envelope to sit higher than the other side but healthy flap tissue should exist underneath.
Bilateral mastectomies were planned through a breast lift incision. Her breasts were reconstructed with DIEP flaps that were microvascularly transplanted from her lower abdomen to her chest. She completed chemotherapy, followed by nipple and areola reconstructions that were performed in the office under local anesthesia.
Next, her right chest wall underwent radiation therapy, as seen in the last set of before and after images. Radiation causes a sunburn like effect to the skin during treatment. These images are shown after her last radiation treatment. Following radiation, the skin redness will fade and the texture of the skin and the breast reconstruction may be slightly firmer. Minimal shrinkage of her right DIEP flap occurred.
Final follow up photos are shown 3 years after her DIEP flaps and around two and a half years after radiation therapy was complete. She has very acceptable symmetry and is able to move forward after facing and fighting breast cancer.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
