PMC5838613_01
Patient 1, a 52-year-old woman with extensive ductal carcinoma in situ who under-went a left mastectomy and TALD reconstruction 1 year later. Note the excellent postoperative symmetry. Photographs prior to nipple reconstruction (a, c, e) and after TALD reconstruction (b, d, f). TALD indicates totally autologous latissimus dorsi.
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F1
The breasts exhibited a degree of ptosis (Figs 1a and 1c). Her reconstruction was successful with excellent cosmetic results (Figs 1b, 1d, and 1f).
PMC5838613_02
Patient 2, a 40-year old female with A cup size breasts and body mass index of 20, shown preoperatively (a, c, e) and 1 year following immediate left breast reconstruction with a totally autologous latissimus dorsi flap (b, d, f) and nipple-areolar reconstruction with acceptable cosmetic results.
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F2
There was insufficient tissue on the buttocks and thighs, and abdominal skin closure would have been too tight for an abdominal flap. The cosmetic results (Figs 2b, 2d, and 2f) were assessed as acceptable, and she suffered no complications from the mastectomy (91 g of breast tissue removed) or the simultaneous sentinel lymph node biopsy.
PMC5838613_03
Patient 3, a 54-year-old woman with a body mass index of 26 and 36A/B cup-sized breasts, undertook a left breast latissimus dorsi reconstruction as demonstrated in the preoperative (a, c, e) and postoperative (b, d, f) photographs. She previously had a right skin-sparing mastectomy and reconstruction with a pediceled TRAM flap.
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F3
TRAM flap for a contralateral cancer (Figs 3a, 3c, and 3e). Therefore, the abdominal tissue was no longer available for the reconstruction and there was inadequate tissue on the inner thigh, upper buttock, and lower buttock. She was very pleased with the cosmetic outcome, which was assessed as acceptable (Figs 3b, 3d, and 3f).
PMC5838613_04
Patient 4, a 45-year-old woman with 36B cup size breasts and body mass index 27, shown preoperatively (a, c, e,) and 1-year after reconstruction (b, d, f). The nipple reconstruction has produced good cosmetic results, and there is reasonable donor site scarring. The breast mounds on the left-lateral view (e, f) highlight that there is more than adequate volume to match the opposite breast.
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F4
The cosmetic results were excellent (Figs 4b, 4d, and 4f), and there were no postoperative complications.
PMC5838613_05