PMC8012792_01
Breast tissues condition with presence of an extended hard-full-thickness scar with many subcutaneous nodules bilaterally and a complete deformity of the breast cone with nipple-areola complex herniation.
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PMC8012792_01_10-1055-s-0040-1721862_7_0654_01.jpg
FI-1
Computer tomography scan showing an important and dishomogeneous increase in thickness of breast tissues with the presence of hyperdense nodules of silicone.
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FI-2
Breast tissues showed an important and dishomogeneous increase in thickness with presence of hyperdense nodules of silicone ( Fig. 2 ).
Preoperative planning of scar removal and reconstruction with bilateral deep inferior epigastric perforator flap. Perforators are marked with.
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FI-3
We also planned a simultaneous reconstruction with a deep inferior epigastric perforator flap ( Fig. 3 ) because of the wide bilateral involved area and the possibility of sternal exposure.
The debridement was carried out involving also the muscular fascia and part of the muscular superficial plane that was broadly filled with liquid silicone.
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FI-4
The debridement was performed involving also part of the muscular plane that was broadly filled with liquid silicone ( Fig. 4 ).
Intraoperative incision (
A
) and perforators and nutrient vessels dissection (
B
).
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PMC8012792_01_10-1055-s-0040-1721862_7_0654_05.jpg
FI-5
The flap was harvested bilaterally based on a preoperative computed tomography angiography to determine the exact position of perforators ( Figs. 5A 5B ).
Postoperative picture showing the patient after 3 months from the operation.
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FI-6
A compressive abdominal girdle was applied and physical activity was avoided for 6 weeks ( Fig. 6 ).