Before and after bilateral mastectomies and autogenous tissue abreast reconstruction with a combination of bilateral DIEP flaps and secondary implants placed beneath the flaps in a 34-year-old breast cancer survivor who had positive margins after a large lumpectomy. She wanted to use her own tissue for her breast reconstruction and was an excellent candidate for the DIEP flap to create two new breasts.
Following successful microvascular transplantation of abdominal tissue to the chest, with preservation of her own nipples and areolas that were replaced on the breast as free NAC (nipple-areola complex) autografts, she lost a significant amount of weight, and with that, much of her flap volume.
Fat cells do not know that they are in a new location after they are transplanted to a new location in a free flap (or after fat grafting); they will shrink with weight loss after surgery. This is why a stable weight should be maintained both before and after surgery. Gaining weight to try to increase potential DIEP flap volume before surgery will only be reversed with natural weight loss afterward.
A year after her DIEP flaps and once her weight was stable, breast implants were inserted under her flaps to help provide additional volume and increased projection to her breast reconstruction. Long-term follow up photos are shown 6 years after surgery with mature scars, a natural looking result and a happy patient!
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
