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Before and after bilateral mastectomy and hybrid DIEP flap and implant breast reconstruction in a 54-year-old breast cancer survivor. She had invasive breast cancer of one breast; she chose to have both breasts removed and wanted to use her tummy tissue for reconstruction.

She had a double mastectomy and immediate breast reconstruction using her lower abdominal skin and fat, preserving the blood supply to the tissue using the deep inferior artery perforator and its accompanying veins. Her nipples and areolas were lifted with a mastopexy (breast lift) at the same time.

After surgery, she changed her lifestyle, got physically fit and lost weight which resulted in loss of her breast volume. When fat cells are transplanted from one area of the body to another, they do not know they are in a new location. Weight gain will cause the fat cells to grow, and weight loss will cause their size to shrink.

Several years later, she requested a revision of her breast reconstruction to achieve improved projection and a slight increase in her volume. Smooth round silicone gel breast implants were placed on top of the muscle and under the DIEP flaps, in the prepectoral position.

Long-term follow up photos are shown 5 years after surgery. she considers this surgery her “Mommy Makeover”, in addition to her breast cancer makeover and a new lease on life!

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

Dr Karen Horton