Breast reconstruction is a common procedure in the United States and more specifically in Newport Beach, California. Often patients may have undergone a bilateral mastectomy with implant reconstruction. At the time of the mastectomy, the nipple areola complex may have been removed and the breast reconstructed with tissue expanders and then subsequently the placement of bilateral mammary prosthesis.
When the remaining mastectomy skin is thin, the patient may often be bothered by waviness and rippling. The implant is not only palpable through the skin, but also visible as the thin skin can become translucent.
When patients want to remove their mammary prosthesis, the mastectomy skin is opened and the implant is removed. The pectoralis major muscle is reattached to the chest wall and the interspace of the 3rd rib gains access to the internal mammary artery and vein. The mastectomy defect in the pre-pectoral plane is re-created. The DIEP flaps are then harvested from the abdomen and placed above the pectoralis muscle to re-create the natural appearance of the breast. The skin paddle from the abdomen is used to replace the skin where the nipple areola complex used to be. This creates more projection to the reconstructed breast mounds.
The improvement in the abdominal contour is a nice secondary benefit to the autologous flap reconstruction.