When the mastectomy has been radiated and there is either a tissue expander or implant beneath the radiated pocket, a capsular contracture can develop which displaced the implant to a more superior location. When an implant reconstruction is not possible or favorable secondary to the radiation, then the breast can be reconstructed with a DIEP flap. In a DIEP flap the abdominal tissue is harvested from the abdomen and transferred to the chest and a microsurgical anastomosis is performed to connect the blood supply. The reconstructed breast mound is soft and has similar tissue characteristics to the contralateral breast.
The photograph above shows the flight plan for the left breast DIEP flap reconstruction. The dimensions of the right breast are traced onto the abdominal wall and the abdominal tissue is harvested and transferred to the left chest.