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Before and after bilateral breast reconstruction revision in a 45 year old breast cancer survivor. She previously had non-skin sparing mastectomies and tissue expanders placed before finishing chemotherapy and having radiation to her right chest wall.

Her expanders were tight and painful; she wished to have a softer, more natural breast reconstruction. Thanks to her body habitus, she was an ideal candidate for the DIEP flap!

Her submuscular tissue expanders were removed and her pectoralis major muscles were returned and restored to the chest wall. Skin and fat from her lower abdomen were microsurgically transplanted to her chest via the deep inferior epigastric artery perforator (DIEP) and two veins were also anastomosed to ensure excellent blood flow into and out of the flap.

9 months later, she underwent liposuction and fat grafting to smooth out residual fat in her abdomen and flanks. Nipples and areolas were reconstructed using 3-D medical tattoo. Follow up photos are shown 3 months after her second stage procedure.

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

Dr Karen Horton