Before and after delayed DIEP flap breast reconstruction in a 55 year old woman. She had previously undergone a left mastectomy and chemotherapy but was unfortunately offered any reconstruction!
She did not wish to have an implant for reconstruction and she had more than enough abdominal skin and fat to make a new breast. She wished to be lifted on the right side and to get rid of her belly fat.
A left sided DIEP flap microsurgically transplanted skin and fat from her lower abdomen (including some stretch marks) to her left chest based on the deep inferior epigastric artery perforator (DIEP blood vessels), creating a new breast mound. A right sided mastopexy (breast lift) reshaped her right breast into a more youthful position and lifted the nipple and areola to a higher position on the breast.
Follow up photos are shown at 3 months after surgery. Her incisions are pink or brown which is expected for this early stage of healing. At approximately 6 months, she will be offered nipple and areola reconstruction on the left side together with free fat grafting, which will further contour her DIEP flap donor site (abdomen and flanks).
Her options for nipple and areola reconstruction include a right to left free nipple graft – also known as “nipple sharing” – or a local flap and tattoo. Both options are good, but using natural nipple tissue provides the most natural aesthetic results, without sacrificing sensation to the “donor nipple”, which will end up being half its original size.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
