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Before and after bilateral DIEP flap and sub-flap implant reconstruction in a 63 year old woman with bilateral breast cancer. She had had breast implants for years – they lay low on her chest, creating a hollowed out upper pole. She also had a ventral hernia from past abdominal surgery.

She wanted to use her own tissue for breast reconstruction and understood she would likely need implants beneath her flap to achieve her particular aesthetic goals, which was to have increased fullness but no rippling or other signs of implant reconstruction.

A two stage procedure was planned. First, nipple sparing mastectomies were performed at the same time as DIEP flap reconstructions. Her ventral abdominal hernia was repaired by rectus fascial plication with mesh reinforcement. Six months later, implants were placed beneath the flaps in the prepectoral position.

Follow up photos are shown 4 months after her second and final procedure. Her scars are maturing, she has a natural looking, perky and proportional result, and she is very happy to come back and see us for long term follow up!

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

Dr Karen Horton