48 year old African American patient presented with left breast cancer. Her history began with a left breast mass that was initially treated with a lumpectomy by a breast surgeon. Unfortunately, the patient had positive margins on her final pathology and was then offered a mastectomy to completely resect the disease in her left breast. After not being a good lumpectomy candidate, the patient opted to also have a right mastectomy as well. After visiting with her surgeon at Memorial Plastic Surgery, she was not a nipple sparing candidate however an areola sparing mastectomy with immediate DIEP flap reconstruction was offered in order to optimize her cosmetic outcome.
Areola sparing mastectomy was performed in the the first surgery with immediate DIEP flap reconstruction of both breast. She is seen here 4 months out after healing from her initial mastectomy with acceptable breast mounds but some mild contour irregularities in the upper poles of both breasts.
Her first revisional surgery included aggressive liposuction to the flanks and abdomen with fat grafting to the upper chest to improve overall contour. The irregularities of the upper pole of the breast were smoothed out with fat that was suctioned from her abdomen.
Patient decided to undergo a second round of liposuction and fat grafting to improve overall outcome. Additional liposuction of the abdomen and waist area improved her body contour and the fat was purified and grafted (injected) into both breasts to obtain more volume without using implants.
Nipple reconstruction was performed with the same areola skin that was spared with modified CV flaps. Patient is seen below 6 months out after nipple reconstruction with stable and acceptable reconstruction.
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