PMC10304431_01
Pre-operative drawings of the skin island of the DIEP flap and the selected left-side perforator, for immediate reconstruction following the planned right breast skin-sparing mastectomy.
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The patient had two pregnancies and a Body Mass Index of 28,2kg/m2 (Figure 1).
Post-operative view at 6 months following the immediate DIEP flap-based right breast reconstruction; a significant asymmetry is Present, as no symmetrisation surgery was performed on the left breast.
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As the patient did not wish to have any symmetrization procedure on her left healthy breast, a post-operative breast asymmetry was obviously expected (Figure 2).
Intraoperative view of the fat-augmented latissimus dorsi (FALD) flap after the fat injections into the LD flap, the left pectoralis major muscle, the mastectomy skin flaps and the de-epithelialized dermo-fatty pedicle of the lower breast pole.
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A myo-cutaneous latissimus dorsi (LD) flap with a skin island measuring 12 x 6 cm, was elevated and transposed to the anterior thorax through a sub-cutaneous axillary tunnel (Figure 3).
Post-operative result at 10-month follow-up after the left breast reconstruction, when additional lipofilling was Decided for better symmetry between the two reconstructed breasts (a); final post-operative result at 20-month follow-up after the second lipofilling session (b).
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Patient satisfaction was measured through the Breast-Q breast reconstruction module at twenty months (Figure 4) and revealed high scores regarding satisfaction with both breasts.