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Before and after delayed breast reconstruction using the DIEP flap in a 41 year old mother of three. She had previously undergone chemotherapy, bilateral non-nipple sparing mastectomies and an attempt at implant reconstruction and nipple-areolar reconstruction. Due to radiation damage, she lost her left implant and sought another option, using her body’s own tissue.

The right-sided implant was removed from under the pectoralis muscle, and a bilateral DIEP flap breast reconstruction was performed. Secondary nipple and areola reconstruction took place one year later, together with free fat grafting to her chest wall. This provided additional contour benefit to her abdominal donor site and helped to fill in subtle residual hollows on her chest wall.

Follow up photos are shown three years after surgery. This patient has naturally dark skin and she creates hyperpigmented (brown) and hypertrophic scars (excess collagen production). She is still actively using scar gel. Based on past surgeries and injuries, she knows that it takes her scars at least 5 years for her scars to fade.

She has regained a positive body image, is working full time as a professional and busy Mom, and feels great wearing a bikini! The DIEP flap helped her move forward following fighting breast cancer successfully at a young age.

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

Dr Karen Horton