Before and after breast reconstruction revision in a 68-year-old breast cancer survivor. She was reconstructed originally with a right-sided TRAM flap – an older technique that uses skin and fat from the middle abdomen, basing its blood supply on the rectus abdominis muscle which is flipped upwards to move soft tissue up to the chest.
This method has largely been replaced by the DIEP flap, a microsurgical technique which saves the abdominal muscles and moves the tissue microvascularly rather than relying on a muscle to carry the blood supply.
This patient presented with breast asymmetry due to menopause and weight gain, resulting in her native left breast being larger than the left TRAM flap. Consequently, her bras pulled to the left, resulting in her constantly trying to fix her bra in her shirts. Her past areola tattoo had faded, which added to the asymmetry.
Her revision involved performing a breast reduction and lift on the left to better match the right, a local tissue rearrangement of the right TRAM flap and medical tattoo of both areolas. Follow up photos are shown 5 months after surgery.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
