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Before and after bilateral delayed breast reconstruction with a hybrid of DIEP flaps and sub-flap implants in a 38-year-old breast cancer survivor. She was not offered reconstruction at the time of her breast cancer diagnosis and treatment.

After she completed chemotherapy and radiation, she sought breast reconstruction using her own tissue. She wanted a breast reconstruction result similar to her original preoperative breast size, which was a full DD, to best reestablish her body image and to help her feel whole again.

Bilateral DIEP flaps transplanted abdominal skin and fat to her chest, creating two breast mounds that served as an excellent foundation for future implants. The missing skin and soft tissue removed during her mastectomies was replaced.

Six months later, smooth round saline-filled permanent and postoperatively adjustable implants were placed beneath the flaps, in the prepectoral position. They were inflated a few times after surgery so that the patient could choose her own breast size, volume and projection.

The remote implant ports were removed in a final reconstructive stage three months later, at the same time as nipple and areola reconstruction. Follow up photos are shown 1 year after her DIEP flap surgery and 6 months after sub-DIEP flap augmentation.

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

Dr Karen Horton