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Before and after bilateral explantation of completely submuscular implants previously placed for breast reconstruction and replacement with deep inferior epigastric artery perforator (DIEP) flap microvascular transplants.

This patient had a severe motion deformity whenever she used her chest muscles. The implants were removed, her pectoralis major muscles were replaced to her chest wall to reconstruct her normal anatomy, and DIEP flaps were placed in the space underneath the breast skin – just like normal breast tissue.

A skin paddle from the abdomen was left showing in the center of the breast reconstruction to allow the mastectomy skin to expand and have natural droop, just like a real breast.

Early follow up images are shown at 2 months after surgery. At 6-12 months after her DIEP flaps, she will undergo bilateral nipple and areola reconstruction and possible free fat grafting for additional contouring.

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

Dr Karen Horton