Description:

Deep inferior epigastric perforator flap DIEP.  Nipple sparing mastectomy for breast cancer. While abdominal scars do exist they are similar to those of a abdominoplasty/tummy talk. Underwear Underwear or bathing suit selection can help make those difficult to see.

Description:

Followup from implant-based breast reconstruction for breast cancer risk reduction. This woman’s sister and mother had breast cancer. To reduce her own risk she underwent bilateral (double) mastectomies. Tissue expanders were placed at first and were later replaced with silicone implants. Her nipples were saved so she has a very natural appearance. She wears low-cut evening gowns and bikinis with confidence. She says that she goes for days without remembering that she has had her breast removed.

1st – pre op. 2nd – post op (note the increased symmetry). 3rd – post op in bra. 4th – post op in clothes.

Description:

One year follow up from breast reconstruction with implants for a nipple sparing mastectomy. This patient is quite happy with her results and achieved her goal of a natural appearing reconstruction with a slight increase in size. It should be noted that in some in some individuals scars are noticeable at a year and often darker scars or thicker scars are a result of genetics instead of technique.

Description:

This patient underwent breast reconstruction with a deep inferior epigastric perforator flop (Diep Flap). She had undergone a mastectomy for breast cancer and also had treated with chemotherapy. She has gone on to have nipple reconstruction, but has not yet had nipple tattooing. In addition to having had her breast reconstructed the effects of the abdominal portion of the Diep Flap plus weight loss has significantly transformed her body. One other important detail is that this patient had undergone a breast reduction prior to being diagnosed with breast cancer, and those scars can be seen in the preoperative photographs.

Description:

Three month follow up from implant based breast reconstruction following bilateral nipple sparing mastectomy (double mastectomy). The implants are pre-pectoral (above the muscle) and an acellular dermal matrix was used. This patient also underwent nerve reconstruction to restore sensation to the nipple which is important for many women for intimacy and to prevent injury to the skin. This is a thin patient and the photos demonstrate some of the limitations in this patient population. On the side and three-quarters view a small amount of rippling is seen and a small crease or valley on the outer edge of the implant. While seen in heavier patients, these features are less noticeable in heavier patients because the mastectomy and adjacent skin is thicker and there is more fat to use for fat grafting to smooth away the contour irregularities. Another thing to consider is that the path of the reconstructed nerve is located on the outer edge of the breast. The need to protect the nerve limits some of the techniques used to smooth those areas. This patient is very happy and recognizes the limitations and compromises.

Description:

Unilateral (her left) breast reconstruction with diep flap. This comparison shows how with the unilateral reconstruction there are often some asymmetries that are noticeable when naked, but when in clothing, even as little as a bra or a bathing suit, the breast can appear extremely symmetric. While bilateral mastectomies and reconstruction often create more symmetry than unilateral mastectomy and reconstruction there are good reasons to do a mastectomy on one or both breast, and appearance is not the only factor in that consideration. A conversation with your breast surgeon and with a plastic surgeon can help you through these decisions. What I hope you take away from this image, though, is that with unilateral reconstruction, and even a minimal amount of clothing symmetry is quite achievable.

Description:

This patient underwent implant-based brush reconstruction after mastectomy. The first photo demonstrates her preoperative appearance prior to mastectomy she had undergone cosmetic breast surgery elsewhere. She then underwent implant-based breast reconstruction for mastectomy that started with tissue expanders and ended with implants using fat grafting to help reduce rippling and create natural contours. The second two photos show her results. It should also be noted that this patient desired a very full look with significant superior pole projection.

Description:

This woman underwent a bilateral deep inferior epigastric perforator flap (DIEP flap) with for breast reconstruction for mastectomy using nipple sparing technique. With this mastectomy type, all of the breast tissue is removed, leaving behind all of the overly skin and lens itself to very natural results. Not all patients are candidates for this. Whether this technique is advisable for any particular, patient should be determined with a conversation with their breast surgeon. A DIEP Flap is a reconstructive method where tissue from the abdomen Is transferred using microsurgery to the chest. With his procedure, a patient also essentially gets abdominoplasty like results in the abdomen.

Description:

This patient underwent a bilateral skin sparing mastectomies and reconstruction with bilateral DIEP flaps. Her surgery was unique, and that we were able to preserve the nipple tissue by grafting it back onto her breast. She has very fair skin, and so the appearance of a nipple will be augmented by tattooing later in her career.

Description:

This woman is 54 years old and underwent a bilateral nipple sparing, mastectomy, and implant based reconstruction. This is a two step process for the patient undergoes a mastectomy and placement of a tissue expander and a collagen sheet called an acellular dermal matrix. A patient then comes back at about 4 to 5 months for removal of the tissue expander and placement of a Silicone breast implant. Often fat grafting at that second surgery can help create more natural contours.