40 year old caucasian female presented with newly diagnosed right breast cancer. Patient had her first mammogram performed demonstrating a suspicious mass at the 6 o\'clock position of the right breast. She had two previous pregnancies and was an excellent candidate for DIEP flap reconstruction of both breasts given her excess skin and fat in the lower abdominal area. She elected to have both breasts removed and also desired to be of larger breast size if possible.
The bilateral mastectomy and immediate DIEP flap reconstruction was performed at the first surgery to create breast mounds. Her nipple and areola were not spared and that skin was replaced with skin from her abdomen. Symmetrical stable breasts mounds are seen in this patient after the first stage and she is seen three months out while undergoing chemotherapy.
The patient expressed a strong desire to be of larger bra size and at the first revisional surgery, implants were placed behind the DIEP flap and muscle to increase volume, projection and improve shape. Additional liposuction was also performed in the abdomen and waist to improve body contour. The fat that was suctioned was saved, purified and then grafted (injected) to the breast and upper poles to additionally gain more volume and smooth out contour irregularities. The nipple was also reconstructed at this stage as well.
The 3D tattoo is done in the office and does not require any anesthesia. The finishing touches that brings a completed reconstruction to life include the pigmentation to restore the areolar color. This patient is seen 6 months out after the completion of her 3D tattoo with a stable reconstruction, symmetrical breast mounds and an acceptable result.
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