Liz
PROCEDURES
Bilateral mastectomies
Bilateral DIEP flap
Revision reconstruction/Nipple Reconstruction
Nipple areola tattoo
Bilateral DIEP flap
Revision reconstruction/Nipple Reconstruction
Nipple areola tattoo
Case Overview
Liz is a 45 year old female who felt a mass in her right breast. She underwent imaging and biopsies that revealed invasive ductal carcinoma of the right breast and metastasis to an axillary lymph node metastasis. Liz began her treatment with neoadjuvant chemotherapy. She opted to proceed with bilateral skin sparing mastectomies. Nipple sparing mastectomies were not considered due to the proximity of the tumor to the nipple and her grade III ptosis.
Surgeon
David Light, M.D.
Before
After
Pre-operative before bilateral mastectomies with DIEP flap breast reconstruction
These images show the patient before surgery. Her tumor’s proximity to her nipple and her breast shape and position ruled out nipple-sparing mastectomies.
After bilateral mastectomies and DIEP flap breast reconstruction
Liz underwent a bilateral skin sparing mastectomies through periareolar incisions (incisions around the nipple areola complex) and DIEP flap breast reconstruction. Her large, ptotic breasts left excess breast skin which was lifted and tightened using the periareolar incision. Despite efforts to tighten the breast skin, there was still excess breast skin, an asymmetry in the breast size, and contour deformities (mostly along the upper border of the breasts) which we planned to address during her revision.
After breast reconstruction revision
Approximately six months after her DIEP flap, Liz underwent a revision procedure. Many patients will undergo a revision procedure 3 months after their DIEP flap, but Liz opted to push the procedure out further to lose additional weight. The revision procedure included nipple areola reconstruction, tightening the breast skin and elevating the nipple position using a periareolar mastopexy technique, fat grafting to increase the breast volume and correct contour deformities along the superior portion of both breasts, and excision of excess skin along the lateral portions of the abdominal donor-site scar. Although the goal of the abdominal liposuction is to harvest fat to graft into the breast, care was taken to execute it such that it enhanced both the abdominal contour as well.
After nipple areola tattoo
Liz’s final breast reconstruction included tattooing her reconstructed nipple areola. These images show her after the tattooing procedure.
