55 year old healthy mother of two presented to Memorial Plastic Surgery with newly diagnosed left breast cancer. While undergoing her yearly scheduled mammogram, she was found to have a 1.3 cm suspicious mass at the 11 o\\\'clock position of the left breast. An ultrasound guided core biopsy was performed and a diagnosis of infiltrating ductal carcinoma was confirmed. Patient desired to have a mastectomy and elected for both breasts to be removed with the right being preventative. She was not a good candidate for nipple sparing given her low positioned nipple but an excellent candidate for immediate DIEP flap reconstruction given her two previous pregnancies and excess skin and fat in the lower abdomen.
Patient underwent a bilateral mastectomy in conjunction with immediate DIEP flap reconstruction of both breasts on the same day. A lift was also performed at the same time in order to raise her nipple position for optimal final result. Symmetrical breast mounds are created in the first stage of surgery and patient is seen below three months out after her mastectomy and DIEP flap reconstruction.
Second surgery in breast reconstruction is revisional surgery. Revisional surgery is typically day surgery with a weekend worth of recovery. In this second stage, the patient had aggressive liposuction of the abdomen and waist to improve body contour. The fat suctioned was saved, purified and then grafted (injected) into the upper poles of both breasts in order to smooth out any contour irregularities and optimize upper pole fullness. She also had nipple reconstruction performed at the same time with free earlobe grafts. Patient is seen below three months after healing from her first revisional surgery.
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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