Before and after bilateral DIEP flap breast reconstructions in a 48-year-old breast cancer survivor. After undergoing a right lumpectomy and radiation therapy for breast cancer, she developed a new tumor in her right breast requiring a mastectomy.
Gene testing revealed she was a carrier for the BRCA gene, so she chose a bilateral mastectomy and autogenous tissue reconstruction using her lower abdominal skin and fat as bilateral DIEP flaps. Tissue from her lower abdomen was microvascularly transplanted to the chest as free tissue transfers.
Her left nipple and areola was preserved and moved higher up on the breast as a free nipple-areolar complex graft. She had enough abdominal tissue to be reconstructed larger than her preoperative breast size, which was her aesthetic goal for reconstruction.
Her right nipple and areola required removal, so one year later, reconstruction of the right nipple-areolar complex was performed using a left-to-right free nipple graft (also called “nipple sharing”) and medical tattoo to create a new areolar circle on the left. The left areola was also tattooed for symmetry.
Long-term follow up photos are shown 3 years after DIEP flap surgery, with very good breast symmetry and mature scars.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
