Before and after bilateral breast reconstruction revision in a 67-year-old breast cancer survivor. Her submuscular implants were contracted, painful and deformed. After having several breast implant revision surgeries with a worse outcome each time, she was elated to know that she had another option – using her body’s own tissue!
The old saline implants were removed, the original breast pocket was recreated, and her pectoralis major muscles were returned to the chest wall and reconstructed. Skin and fat was elevated as a DIEP flap from her lower abdomen and isolated on one artery – the deep inferior epigastric artery perforator – and two veins – the deep inferior epigastric veins and a second superficial inferior epigastric vein.
The blood vessels were isolated under the operating microscope and divided, then the flaps were brought up to the chest area and reconnected via hand-sewing under high powered magnification to blood vessels in the chest – the internal mammary artery and veins. A second “venous anastomosis” was performed in the axillary region, using a venous coupler to allow for a second site of venous drainage.
The abdomen was closed like a tummy tuck, and the patient gave herself six weeks for surgical recovery before resuming tennis and golf. Follow up photos are shown a year and a half after surgery, with maturing scars and a greatly improved aesthetic outcome. She is a candidate for paramedical tattoo in the future for nipple and areola reconstruction.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
