41 year old mother presented with suspicious calcifications in the left breast on her yearly screening mammogram. Patient desired to have immediate reconstruction with DIEP flap reconstruction in a single nipple sparing mastectomy surgery and deemed an excellent candidate by her breast surgeon and surgeon at Memorial Plastic Surgery. Nipple sparing mastectomy was performed through an incision that started at her nipple and ended at the fold of her breast.
Patient had a successful reconstruction of the right breast with DIEP flap however sustained a clot in the left breast on the fourth day in the hospital where the flap was lost. The flap was removed and then a tissue expander placed on the left side to reconstruct that breast. She is seen 3 months out just before her first revisional surgery.
The first revisional surgery included removal of left breast tissue expander, placement of permanent implant with Alloderm to the lower pole and aggressive fat grafting to both breasts. The fat was liposuctioned from the abdomen and waist in order to improve body contour. Although the left DIEP flap was lost, a symmetrical reconstruction was still achieved with an implant on the left.
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