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Before and after left DIEP flap breast reconstruction in a 55 year old breast cancer survivor. She previously had undergone two large left lumpectomies, radiation therapy and chemotherapy. She had attempted an implant reconstruction on the left but due to wound healing problems secondary to radiation, the implant required removal.

She had enough lower abdominal tissue to reconstruct her breast. A left completion mastectomy was planned to clear out remaining damaged radiated tissue at the time of her DIEP flap reconstruction. She had already had a right sided breast reduction and lift – her goal was for her left breast to match her right.

A completion mastectomy was performed on the left and a deep inferior epigastric artery perforator flap reconstruction reconstructed her left breast. Six months later, she underwent nipple areola tattoo to brighten up her nipples and areolas and free fat grafting to add some additional volume to her left upper pole (but primarily to further contour her abdominal donor site).

Fat was harvested from her flanks, abdomen, thighs and bra roll regions. It is our practice to harvest more fat than we need for grafting, because after all, breast cancer survivors deserve to have the very best aesthetic results for their bodies after breast reconstruction! See the last image in this series of before and afters to see what liposuction fat looks like (2 of these canisters were harvested, to the benefit of our patient!).

Follow up photos are shown 8 months after her DIEP flap and 2 months after her second stage surgery. She is so happy to finally be done with wearing breast prostheses in her bra and to be able to move forward after breast cancer!

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*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.

Dr Karen Horton