46 year old mother of two and busy flight attendant presented with a chronically enlarging left breast over the course of 1 year. Because of her busy schedule, patient continued to work despite having multiple mammograms and biopsies that all returned back benign or unequivocal. Mass continued to grow and patient was eventually seen by a breast surgeon. Further incisional biopsy all returned back with an inconclusive diagnosis. Patient was then seen by Memorial Plastic Surgery where the decision was made cohesively to perform a left mastectomy with immediate DIEP flap reconstruction. A breast reduction would potential leave diseased tissue behind and also result in poorer symmetry. Patient agreed to DIEP flap reconstruction and was an excellent candidate give her multiple pregnancies and moderate amount of excess skin and fat in her lower abdomen.

Surgery 1

Patient is shown below three months after initial left simple mastectomy with immediate DIEP flap reconstruction. The flap is intentionally made larger in order to have excess tissue to shape later. Patient also had a large amount of redundant skin. Patient shows a well healed DIEP flap ready for the next stage of revision that is typically three months after the mastectomy.

Surgery 2

Below shows the patient after revisional surgery which consisted of left nipple reconstruction, reduction of areola skin paddle and liposuction of DIEP flap to surgery shape to match the right breast.

Surgery 3

Further shaping as well as fat grafting was performed to continue to mold the left breast to match the right breast. Each stage typically contains some fat grafting to improve mild contour depressions and irregularities.

3D Tattoo

Final stage of reconstruction restore the entire breast with a 3D tattoo. 3D tattoo was performed in office with professional tattoo artist Kat who pigmented the left breast nipple to match the right breast. Each revision is usually separated by three months concluding in the in office 3D tattoo.