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Breast cancer reconstruction is challenging. In some patients, who do not wish to have implants, we can reconstruct the breast with the patient’s own body tissue. This is called an autologous breast reconstruction.

In the DIEP flap reconstruction, the skin and fat from the abdomen and sometimes a small cuff of rectus muscle is disconnected from the blood supply in the pelvis and transferred to the chest. The DIEP flap is anastomosed to the internal mammary vessels behind the third costal cartilage.

During breast cancer surgery, the nipple areola complex and skin overlying the tumor may need to be removed to clear an anterior margin. In these cases, it is often helpful to replace the missing skin with vascularized skin from another region of the body.

The photograph demonstrated before and after nipple removing mastectomy and DIEP flap reconstruction. Swelling continues to subside over 12-18 months post-surgery.