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Dr. Pannucci: DIEP Breast Reconstruction

Before

Breast Reconstruction
Breast Reconstruction

After

Breast Reconstruction
Breast Reconstruction

Case: 4966

52-year-old female who presented with right breast cancer and underwent Stage 1 breast reconstruction with DIEP free flaps followed by Stage 2 breast reconstruction with small pre-pectoral breast implants, and fat grafting. Follow up photos taken 2 years after initial reconstruction.

Before

Breast Reconstruction
Breast Reconstruction

After

Breast Reconstruction
Breast Reconstruction

Case: 4973

This 61 year old had a failed tissue expander elsewhere, and came to me with her nipple closed to the inframammary fold, and a severe lack of tissue.

 

In a single operation, I did a combined DIEP/SIEA flap (two flaps for one breast) to reconstruct the left breast volume while simultaneously providing skin in the lower pole to improve her breast shape.  She had one operation with no revisions, and is four months from surgery.

Before

Breast Reconstruction
Breast Reconstruction

After

Breast Reconstruction
Breast Reconstruction

Case: 4985

This 57-year-old chose right and left nipple taking mastectomies as her cancer treatment. She had delayed-immediate reconstruction with DIEP flaps, and two subsequent planned revision surgeries (for revision and nipple reconstruction, respectively).

 

She is one year from DIEPS, eight months from revision 1, and 5 months from nipple creation in the photos.

Before

Breast Reconstruction
Breast Reconstruction

After

Breast Reconstruction
Breast Reconstruction

Case: 4808

This 45 year old is now 1.5 years from DIEP breast reconstruction after bilateral mastectomies for cancer.  She had initial wise pattern mastectomy followed by DIEP, and then revision procedures to include nipple reconstruction and areola tattoo.

Before

Breast Reconstruction
Breast Reconstruction

After

Breast Reconstruction
Breast Reconstruction

Case: 4713

This 64 year old breast cancer patient is shown ten months out from DIEP breast reconstruction and 5 months from revision surgery including nipple reconstruction.  She subsequently had areola tattoos.

Before

Breast Reconstruction
Breast Reconstruction

After

Breast Reconstruction
Breast Reconstruction

Case: 3921

46 year old woman with right breast cancer, who had nipple sparing mastectomy and reconstruction with two DIEP flaps.  She is 6 months from surgery in the photos.

Before

Breast Reconstruction
Breast Reconstruction

After

Breast Reconstruction
Breast Reconstruction

Case: 1135

48 years old, bilateral mastectomy for breast cancer. Operation: Stage I immediate bilateral DIEP. Stage II: Nipple reconstruction. Photos at ten months from Stage I and 5 months from Stage II.

Before

Breast Reconstruction
Breast Reconstruction

After

Breast Reconstruction
Breast Reconstruction

Case: 2127

49 year old woman who had mastectomies for breast cancer, followed one week later by bilateral DIEP flaps. She had a Stage II revision for fat grafting and nipple reconstruction. Final photos are 11 months from Stage I and 5 months from Stage II.

Before

Breast Reconstruction
Breast Reconstruction

After

Breast Reconstruction
Breast Reconstruction

Case: 1163

61 year old woman who had Stage I DIEP reconstruction after nipple sparing mastectomy and Stage II medial breast fat grafting and removal of abdominal skin island.  Photos at 8 months from Stage I and 4 months from Stage II.

Before

Breast Reconstruction
Breast Reconstruction

After

Breast Reconstruction
Breast Reconstruction

Case: 2120

61 year old woman who had bilateral mastectomies for breast cancer with Stage I DIEPs and Stage II revision and nipple reconstruction.  Photos at 10 months from DIEP and 5 months from revision.

Before

Breast Reconstruction
Breast Reconstruction

After

Breast Reconstruction
Breast Reconstruction

Case: 1989

49 year old woman who had left mastectomy with radiation, followed by re-radiation for chest wall recurrence. She had Stage I DIEP flap for left breast reconstruction, Stage II DIEP flap revision and left breast fat grafting with revision of another surgeon’s right augmentation/mastopexy, and Stage III nipple reconstruction. Photos at 1.5 years after Stage I, 10 months after Stage III, and 6 months after Stage III.

Before

Breast Reconstruction
Breast Reconstruction

After

Breast Reconstruction
Breast Reconstruction

Case: 1700

37 year old BRCA patient who had bilateral mastectomy and DIEP, followed by one surgery for revision and fat grafting.  Photos are 6 months after DIEP and 3 months after revision.

Before

Breast Reconstruction
Breast Reconstruction

After

Breast Reconstruction
Breast Reconstruction

Case: 1707

56 year old woman with breast cancer who had mastectomies and tissue expanders during COVID, followed by DIEP reconstruction and revision surgeries.  Her photos are 15 months after DIEP flap and 3 months after final revision surgery.

Before

Breast Reconstruction
Breast Reconstruction

After

Breast Reconstruction
Breast Reconstruction

Case: 1418

Patient: 51 year old who had bilateral nipple taking mastectomies for breast cancer.

Reconstruction: Bilateral DIEP flaps.  A small open wound on the right breast (mastectomy flap necrosis) was reconstructed with a full thickness skin graft.  She elected not to have nipple reconstruction.

Photos: 4 months

Before

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Breast Reconstruction

After

Breast Reconstruction
Breast Reconstruction

Case: 1667

57 year old woman who had bilateral mastectomies for breast cancer.  Her definitive reconstruction was bilateral DIEP flaps with subsequent revisions, nipple reconstruction, and areola tattooing.  Final photos are one year after DIEP surgery.

Before

Breast Reconstruction

After

Breast Reconstruction

Case: 435

Patient: 45 years old, bilateral mastectomies for breast cancer

 

Operation: Bilateral immediate free DIEP flaps

 

Photos: 3.5 years

Before

Breast Reconstruction

After

Breast Reconstruction

Case: 436

Patient: 45 year old, prior bilateral breast reduction, now with left breast cancer

 

Operation: Immediate left breast reconstruction with DIEP flap

 

Photos: 7 months

Before

Breast Reconstruction
Breast Reconstruction

After

Breast Reconstruction
Breast Reconstruction

Case: 435

Patient: 56 year old who is 13 years out from mastectomies and belly-based free flaps, now with 70 pound weight loss and deflated appearance of reconstructed breasts

Surgery: Bilateral split-muscle augmentation with 345cc implants

 

Post-op time: 10 weeks

Before

Breast Reconstruction

After

Breast Reconstruction

Case: 436

Patient: 57 years old, history of bilateral mastectomy, prior lost expander on the left.

 

Operation: Stage I left free muscle-sparing TRAM, stage II left breast fat grafting and right tissue expander to implant exchange, stage III left breast fat grafting and nipple/areola creation

 

Photos: 13 months after Stage I, 8 months after stage II, 4 months after stage III

Before

Breast Reconstruction

After

Breast Reconstruction

Case: 435

Patient: 45 years old, BRCA positive, desires nipple sparing mastectomy and immediate reconstruction

Operation: Immediate bilateral reconstruction with free DIEP flaps

Photos: 13 months

Before

Breast Reconstruction

After

Breast Reconstruction

Case: 439

Patient: 52 year old with left breast cancer

Surgery: Stage I left mastectomy and immediate DIEP; Stage II right breast reduction; Stage III left nipple/areola creation and flank contouring

 

Photos: 15 months after Stage I, 11 months after Stage II, 2 months after Stage III

Before

Breast Reconstruction

After

Breast Reconstruction

Case: 440

Patient: 47 year old with history of right breast cancer, mastectomy, and radiation

 

Surgery: Stage I right muscle sparing free TRAM for breast reconstruction; Stage II left breast reduction

 

Photos: 7 months after Stage I, 4 months after Stage II

Image by Greg Rosenke
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