About|Advocacy | Events | Get Involved | Search | For Practitioners

Lara

PROCEDURES
Bilateral DIEP flaps
Bilateral nipple reconstruction and bilateral breast revision
Bilateral nipple-areola tattoo

Case Overview

Lara was diagnosed with triple negative breast carcinoma in situ (DCIS) and chose to proceed with bilateral mastectomies and immediate natural tissue reconstruction with DIEP flaps. A Wise pattern mastectomy incision was used to provide a breast lift at the time of the mastectomies and to match the breast skin to the volume of the flap. This approach required a staged nipple reconstruction and nipple areola tattoo.
Dr. Peter Korn

Surgeon

Peter Korn, M.D.
Preoperative before bilateral breast reduction and lift
Before
After bilateral breast revision surgery, abdominal donor site revision, and umbilical reconstruction (healed after stage 5)
After
^
Pre-operative Before Bilateral DIEP flaps
Wise pattern mastectomies with complete DIEP flap coverage using the patient’s breast skin were planned in response to her ptotic nipple position and relatively small anticipated breast reconstruction size.
Illustration showing stage one of bilateral skin-sparing mastectomies with DIEP flap reconstruction. The first panel shows preoperative breast and abdominal markings. The middle panel shows abdominal skin and fat being transferred to the chest to create new breast volume. The final panel shows the reconstructed breasts and a closed abdomen in a standard tummy tuck fashion.
^
Three months after Stage One
The images show well-healed bilateral breast skin with Wise-pattern scars and that match the volume match of the underlying DIEP flap well. At this point, we planned next steps with the patient, who opted to proceed with bilateral nipple reconstruction, bilateral breast revision reconstruction, and abdominal scar revision.
Illustration showing stage two of bilateral nipple reconstruction. The first panel shows reconstructed breasts without nipples. The center panels show step-by-step creation of small skin flaps that are folded to form new nipple projections. The final panel shows healed reconstructed nipples, which can later be tattooed for color.
^
Four months after Stage Two
After allowing adequate time to heal from bilateral nipple reconstruction, breast revision reconstruction, and abdominal scar revision, the patient was ready to complete the reconstruction with bilateral nipple areola tattoos.
^
One year after Stage One
These images reflect the patient’s final result. Scars will typically continue to fade over the following years.
Last updated on June 4, 2026