Case-31497 Gallery

Before and after bilateral delayed breast reconstruction with the DIEP flap in a 60-year-old breast cancer survivor. When she was diagnosed with breast cancer at age 57, she was told she “was too old” for breast reconstruction! She had no health issues other than a history of breast cancer, for which she did not need chemotherapy or radiation. She also was not offered the option to spare her nipples, which were not involved with the cancer.

She was thrilled to learn about the DIEP flap. She had always dreamed about having a tummy tuck, and now she could have both procedures at once! Two DIEP flaps, one from each side of her lower abdomen, were microsurgically transplanted to the chest on one tiny artery and two tiny veins. She spent five days in the hospital for monitoring of the circulation to the flaps before going home.

The lower abdominal donor site incision is designed just as an abdominoplasty incision is, as low as possible so that it lies within swimsuit bottoms or panties, as shown in the last image. In our opinion, the abdomen result should look just like a tummy tuck – even after a breast reconstruction procedure. The belly button is inset to be a cute little “innie”. If there is rectus abdominis muscle separation, it is closed at the time of DIEP flap donor site closure.

Six months later, she had liposuction contouring of her abdomen and bra rolls. Nipples were reconstructed using the local flap technique, and medical tattoo created two new areola circles. Follow up photos are shown 3 years after her reconstruction. You can see why breast reconstruction is so immensely rewarding – to the patient, her loved ones, and everyone involved in our patients’ care!