She is shown before surgery.

She is shown after the surgery, with a tissue expander in place. Unfortunately, the pathology results made it necessary to recommend radiation therapy, so expansion was postponed until this was completed and she was fully recovered, almost 9 months later.

Her tissue expansion failed because the radiated tissues just did not tolerate the stresses of the expansion process and she was in danger of breaking down the skin over the expander and becoming infected. It was felt that we needed to switch to a technique using her own tissues. she is shown marked for a flap from the abdomen, called a TRAM  flap.

Here, she has undergone reconstruction with a TRAM flap which has worked very nicely. This was quite challenging in that she had multiple abdominal scars from prior surgery which necessitated placing the TRAM flap much higher on the abdomen than usual, giving her a horizontal scar at the level of the belly button rather than the typical "bikini" scar.

She is shown after nipple reconstruction and a lift of the left breast but before fat grafting. The latter is a way of correcting contour depressions in a reconstructed breast to smooth out the contour by using the patient's own fat, obtained by liposuction.

This oblique view shows the nice degree of symmetry acheived by the reconstruction, albeit not perfect.

This patient, ever a character, sent me this photograph of herself in Key West, on vacation. She said that she received many compliments on her reconstruction, of which she is very proud. It was a long and arduous process but worth it to her in the end.