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Updated: March 2011

Left DIEP Flap, Right Breast Lift


Two years after left DIEP flap and right breast lift front
Before
After

This patient required a left mastectomy and chose to undergo breast reconstruction using tissue from her abdomen. She is shown here before and after her left mastectomy and staged reconstruction which included a left DIEP flap and a right breast lift.

Pauline's Breast Reconstruction Story:

 

During the summer of 2008 I found a lump in my left breast. After consulting with my doctor, I was referred to a radiologist for a mammogram and breast ultrasound. The radiologist did not detect anything and informed me that I shouldn’t be concerned. However, as a precaution, my doctor recommended that I consult with a breast surgeon so that I could allay my fears.

I made an appointment with a breast surgeon who examined the area where the lump was found and also did a breast ultrasound. From the look on her face I could tell something was wrong. She suggested that I go to a different facility to have another mammogram and a biopsy of the lump. On August 1st, 2008 I received the most devastating news of my life. The new radiologist called and informed me that the result of the biopsy was cancerous and that I would definitely require some type of surgery.

My daughters and I returned to the breast surgeon to discuss what type of surgery would be appropriate for my specific situation. After a very lengthy discussion and careful consideration, because the lump was situated at the areola, it was decided that I should have a mastectomy as opposed to a lumpectomy. The surgeon also suggested that since I would need breast reconstruction, I should meet with a plastic surgeon to discuss the available options. My girls and I went to see the plastic surgeon with whom we discussed the type of reconstruction that would be performed. I chose to have the abdominal free flap because he would use the tissue from my abdomen and that would result in a more natural feel as well as a flat stomach.

It finally dawned on me that I had breast cancer and would need surgery to have a mastectomy. I thought my “perfect” world was about to expire and I was mortified at the thought of losing one of my very precious and prized assets. For the first time in my life I felt out of control and, except for my decision to have a mastectomy, I was unable to do anything about the cancer growing inside my breast. The surgery was scheduled for September 23, 2008 and would be performed jointly between my breast surgeon and plastic surgeon. She performed the mastectomy while he performed the breast reconstruction. The surgery lasted over 8 hours, and I subsequently woke up with a reconstructed left breast. The healing process was slow and painful but the end result was well worth it.

I had several follow up visits with my plastic surgeon who subsequently performed a lift of my right breast so that it was now the same as the reconstructed breast. The result has been amazing and I feel and look much better. On occasion, depending on what I am wearing I do not even need to wear a bra. My breasts not only look perfect, but are much fuller than prior to my surgeries. There is always a positive to the negative. I look back at my experience as a blessing in disguise because I am still alive to share my story so that other women don’t have to be afraid… there is always hope and life after surviving breast cancer.

I will always be grateful to my breast surgeon and especially my plastic surgeon for performing such a wonderful and outstanding job of reconstructing both of my breasts.

 

Photos and Doctor Commentary

 

Pre-operative

Pauline was diagnosed with left breast cancer and decided to undergo a left mastectomy and DIEP flap breast reconstruction. Before surgery she is noted to have sufficient lower abdominal tissue for a flap reconstruction from her abdomen.

 

Markings for left mastectomy and DIEP flap

Markings were made before surgery to elevate the lower abdominal skin and fat for a DIEP flap breast reconstruction. The left breast was marked for a skin-sparing mastectomy using an oval incision around the nipple-areola. This was designed to allow for preservation of most of her breast skin while planning for a breast lift.

 

7 Months Post-Op DIEP Flap Reconstruction

Early after left breast reconstruction with DIEP flap

This is Pauline early after she recovered from her left breast reconstruction with a DIEP flap. The circular patch of skin located on the front of the left breast has visible stretch marks from her abdomen. This skin will be used for her nipple reconstruction in the future.

 

Markings for right breast lift and left breast revision

Markings for right breast lift and left breast revision

In order to improve her breast symmetry, Pauline required a significant breast lift on her right side. She is seen here with markings for the right breast lift using a short scar technique. She is also marked for a minor revision procedure on the left side.

 

One year after first operation

Healed left DIEP flap and right breast lift

This is Pauline one year after her left DIEP flap breast reconstruction and eight months after her right breast lift. She is now ready for left nipple areola reconstruction as well as additional minor revision of both breasts to improve contour.

 

Markings for left nipple reconstruction and additional revision

Markings for left nipple reconstruction and additional revision

Pauline was marked for left nipple-areola reconstruction using a skate flap and skin graft. She was also marked for fat injection along the upper left breast and for excision of excess skin along the lower aspect of the right breast.

 

Two years after left DIEP flap and right breast lift front 

 Two years after left DIEP flap and right breast lift hr  Two years after left DIEP flap and right breast lift hl

Two years after left DIEP flap and right breast lift left  Two years after left DIEP flap and right breast lift right  

Two years after left DIEP flap and right breast lift

Pauline is well-healed two years after her left DIEP flap which has resulted in a reconstructed breast that looks and feels natural. Also, she has good symmetry following her right breast lift and an improved abdominal contour where the flap was taken. Tattooing of her left reconstructed nipple was done in the office and she now has a good color match with the right side.