Before and after right explantation and DIEP flap reconstruction with a left balancing breast reduction and liposuction of the axillary rolls in a 41-year-old breast cancer survivor. After undergoing several lumpectomies, radiation, chemotherapy, a completion mastectomy and implant reconstruction, she sought relief of pain and tightness from capsular contracture.
Her revision involved removal of the right breast implant, replacement of her pectoralis major muscle to the chest wall, and creation of a new space on top of the muscle, in the prepectoral position. Skin and fat was microvascularly transplanted from the lower abdomen to the chest as a DIEP flap.
A left breast reduction made the left breast a little smaller and corrected significant bottoming-out of the left breast that resulted as a consequence of a past vertical breast reduction. If just a lollipop incision is used in a breast reduction, the nipple ends up sitting too high when heavy breast tissue inevitably droops in the lower pole of the breast. A horizontal incision in the breast fold is needed to remove bottom-heavy breast tissue and redistribute the tension of the bottom of the breast, as is standard for our breast reduction patients.
Liposuction removed excess fat from her armpits and bra rolls in a second procedure, performed six months later. A portion of the left nipple was moved to the right as a free nipple graft to reconstruct the right nipple and provide the most natural looking result. Medical tattoo brightened up her areolar circles.
Follow up photos are shown 4 years after surgery.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
