These photographs show the stages of reconstruction in a BRCA positive woman who presented after already having a right mastectomy and radiation therapy. The patient wanted reconstruction with DIEP Flaps and decided to have a left nipple sparing mastectomy at the time of the reconstruction. The radiated right breast skin was stiff and contracted down to the chest. Her goal was natural symmetrical breasts, about the same size as her original size.
Below is the preoperative photograph.
Below is a photograph of the woman after a delayed (not at the same time as mastectomy) DIEP flap breast reconstruction on the right radiated side, and immediate (at the same time as mastectomy) DIEP flap breast reconstruction on the left prophylactic nipple sparing mastectomy side. Note the abdominal skin needed to create a natural shaped breast reconstruction with reasonable symmetry to the left breast.
Below is a photography of the woman after a right breast nipple reconstruction and minor revision to the abdominal donor site. The abdominal scar will fade more at the year point.