Breast Procedures

Bilateral 3 D Nipple Areola Tattoo performed by specialty artist.

Bilateral implant reconstruction. Nipple areolar complex created with bilateral 3-D tattooing by specialty artist.

Patient with 3-D Nipple Tattoo technique. Previous nipple areolar reconstruction utilizing adjacent tissue transfer.

Patient underwent bilateral GAP flap reconstruction 14 years prior. Presented with faded tattoos at visit - underwent 3-D nipple tattooing with our artist to restore nipple areola complex. Upper photo is pre-procedure - lower photo is post procedure.

3-D Tattooing by specialty artist

3 D nipple areolar tattoo by specialty artist

Patient has permanent implants and 3-D Nipple tattooing.

History of DIEP with with removal of bilateral implants

Stage 2: Bilateral breast revision with fat grafting

Stage 3: Bilateral breast and nipple reconstruction

Bilateral breast augmentation. Patient with diminished breast volume after having children desired to have fullness restored to her breasts.

Patient started as 36A, 2 children

Patient had Bilateral Breast Augmentation and abdominal liposuction. 350 smooth round saline implants. She is a well controlled Type 1 diabetic.

This woman had a Breast augmentation.

Patient had a breast augentation and a tummy tuck. 4 children.

Patient had a breast augmentation.

Patient had a breast augmentatio.

Patient had breast augmentation.

Patient had breast augmentation.

Patient had a breast augmentation.

Patient had breast augmentation.

Patient had breast augmentation

This patient had a breast with with a breast augmentation. Mommy makeover.

Patient had breast augmentation.

Patient had breast augmentation.

Patient had breast augmentation.

Patient had breast augmentation.

Patient got breast augmentation.

Patient had breast augmentation.

Patient had breast augmentation.

Patient had breast augmentation.

Patient had breast augmentation.

Patient had breast augmentation.

Patient had breast augmentation.

Patient had breast augmentation.

Patient had breast augmentation

Patient had breast augmentation

Patient had tummy tuck. Mommy makeover. Breast augmentation.

Patient had tummy tuck and breast augmentation. Mommy makeover.

Patient had tummy tuck and a breast augmentation. Mommy makeover.

Patient had breast augmentation

Patient had Breast Augmentation with a Lift and a Tummy Tuck. 5 Children.

Patient had breast lift.

This patient had a breast with with a breast augmentation. Mommy makeover.

Patient had breast lift.

Patient had tummy tuck. Breast lift. Mommy makeover.

Patient had tummy tuck. Breast lift. Mommy makeover.

Primary right breast reconstruction with unilateral DIEP and ReSensation, immediate reconstruction after right nipple sparing mastectomy, left breast reduction for symmetry

Right DIEP with nipple reconstruction and tattooing

Skin and nipple sparing mastectomy followed by Bilateral DIEP breast reconstruction

Patient with failed implant reconstruction - Bilateral DIEP performed after implant removal

Patient with DCIS right breast - immediate reconstruction with bilateral DIEP flaps.

Skin and nipple sparing mastectomy - skin sparing DIEP with small skin paddles excised at later date

Immediate DIEP to the right breast after mastectomy.

Delayed reconstruction following mastectomy performed nine years prior. Had left unilateral DIEP with a major revision of the left breast, right breast mastopexy for symmetry and excision of bilateral dog ears. Left nipple reconstruction with skate flap followed by nipple tattoing.

Previous reconstruction with tissue expanders followed by implants. Conversion to natural breast reconstruction Bilateral DIEP after implant exposure

Patient after Stage Two Right Unilateral DIEP - Stage three will consist of removal of excess skin and tissue from lateral donor site and fat grafting

Patient with Left Breast DCIS. Immediate reconstruction performed after nipple-sparing mastectomy. Photos are pre-op, after Stage 1, and after Stage 2.

48 year old patient skin and nipple sparing mastectomy. Immediate reconstruction with Bilateral DIEP (deep inferior epigastric perforator breast reconstruction)

Bilateral DIEP with nipple reconstruction

Bilateral DIEP after 2nd stage. Skin sparing mastectomy Anticipate reconstruction of left nipple at later date.

Bilateral Skin and Nipple Sparing Mastectomy - Immediate DIEP breast reconstruction - 3 revisions including fat grafting and donor site revisions.

Patient with high risk of breast cancer underwent skin and nipple sparing prophylactic mastectomies. Breast Reconstruction with Bilateral DIEP flaps from abdomen.

1. breast reduction following left lumpectomy

2. Primary bilateral DIEP with Axogen nerve grafts

3. Open revision bilateral breasts with open complex abdominal revision

4. fat grafting to bilateral breasts

5. Open revision right breast with fat grafting bilateral breasts

Patient with right metastatic IDC treated with radiation. Delayed right DIEP - Immediate left DIEP.

History of breast reconstruction: Failed right TE placement due to inadequate perfusion on the SPY 2019: Bilateral DIEP (Right delayed, left primary)- 2019

Revisions: abdominal donor site revision : Open revision of left breast with fat grafting to bilateral breasts advancement flap to umbilicus, and excision of abdominal dog ears

Patient has prior history of breast reduction.

Patient with a history of left breast cancer - immediate nipple sparing mastectomy followed by bilateral DIEP with Axogen nerve grafts.

Patient underwent primary DIEP after preliminary bilateral mastopexy 3 months earlier. This was followed by revisions of the breast via multiple sessions of fat grafting.

Patient underwent immediate bilateral tissue expander reconstruction following bilateral mastectomies. Expanders were removed and replaced with bilateral DIEP - patient has had one revision and chose decorative tattoo.

Immediate Bilateral DIEP after Skin and Nipple Sparing Mastectomy

History of breast reconstruction: Bilateral DIEP Revision: Open revision bilateral breasts, excision of fat necrosis from left breast, complex abdominal revision : fat grafting to bilateral breasts: Excision of left abdominal dog ear in office: Excision left infra axillary tissue

Abdominal vessel delay

Primary right stacked DIEP

Stage 2: revision of right breast reconstruction, left peri-areolar mastopexy, excision of scar contracture right abdominal donor site and fat grafting to bilateral breasts

Stage 3: left mastopexy for symmetry, fat grafting to right breast - complex abdominal donor site revision.

Patient who underwent bilateral nipple and skin sparing mastectomies followed by immediate DIEP breast reconstruction. The photo listed under BEFORE is after her initial procedure. She has had revision of her donor site dog ear (pictured in After #1), and fat grafting to the upper poles of the breast. Her final result is After #2.

2019 had reduction/mastopexy for nipple preservation and abdominal vessel delay

2019 Primary bilateral DIEP- flap with bilateral Axogen nerve grafts, stage 1

Stage 2 2020: Bilateral open breast revision with removal of fat necrosis, abdominal donor site revision with excision of dog ears

Stage 3 2020: open revision of bilateral breasts with fat grafting

Stage 4 2020: bilateral breast revision, reconstruction of upper and lower abdominal wall, upper plication of diastasis/reconstruction of left lower abdominal rectus sheath and fat grafting to bilateral breasts

Stage 5 2020: Minor revision of left breast with excision of scar contracture anterior axillary fold left chest, and fat grafting to bilateral breasts

History of bilateral skin and nipple sparing masectomy with immediate bilateral DIEP. Photos are Pre initial operation and Post four revisions.

Bilateral DIEP with Axogen nerve grafts

Stage 2: Open revision of bilateral breasts and excision of abdominal dog ears

Stage 3: Fat grafting to bilateral breasts (R-90 mL, L-90 mL), and complex abdominal donor site revision with diastasis repair

Primary bilateral DIEP with bilateral Axogen nerve grafts

Stage 2: Open revision of bilateral breasts with excision of fat necrosis, evacuation of chronic seroma cavity and abdominal donor site revision with vest-over-pants fasciocutaneous flap

Stage 3: Fat grafting to bilateral breasts R-110cc, L-120cc, excision of right abdominal dog ear, and removal of chemo port

Immediate Bilaterial DIEP following Bilateral nipple sparing mastectomy. Photos are Pre Op and Post Stage 3 revisions.

Patient has a history of Bilateral breast reduction/mastopexy for nipple preservation following right lumpectomy.

Photos are from Pre Op Primary bilateral DIEP with right Axogen nerve graft and following Stage 2 bilateral breast revision with excision of fat necrosis and skin paddles and complex abdominal revision.

Patient has history of bilateral breast masectomy. Photos are of Pre Op bilateral breast implant removal with immediate bilateral DIEP and Post Stage 2 bilateral breast revision with reduction of right breast for a more even look.

Patient has a history of bilateral mastectomy. Photos are Pre breast recontruction using bilateral DIEP with bilateral Axogen nerve grafts. Second photo is post 2 revision surgeries.

Patient with DCIS left breast immediate reconstruction performed after skin sparing mastectomy. Photos are pre-op, after Stage 1, and after Stage 3 completed with nipple reconstruction and areolar tattooing.

Patient has history of skin and nipple sparing mastectomy of left breast with immediate breast reconstruction with implant placement and 7 months later nipple sparing mastectomy of right breast with immediate bilateral (right primary) DIEP with removal of initial left implant. Picture are Pre initial mastectomy and post Stage 2 revision of both breasts.

Skin sparing mastectomy - DIEP with skin sparing mastectomy, no nipple reconstruction

Delayed bilateral DIEP, 3-D Nipple Areola Tattooing

BRCA positive patient who chose prophylactic skin sparing mastectomy followed by immediate bilateral DIEP breast reconstruction. Revision procedures included Bilateral breast reconstruction revision, abdominal wall reconstruction with vest-over-pants fasciocutaneous flaps, and fat grafting removal of bilateral abdominal dog ear deformities

4/2009: History of bilateral non skin/nipple-sparing mastectomy with bilateral TE placement

5/2009: Bilateral TE to implant exchange

2011: Bilateral implant exchange

8/2019: Bilateral implant removal with bilateral DIEP and bilateral Axogen nerve grafts

12/2019 Stage 2 bilateral breast reconstruction revision

History of breast reconstruction: Bilateral breast reduction/mastopexy for nipple preservation : Primary bilateral DIEP with bilateral axogen nerve grafts : Bilateral breast revision with complex abdominal donor site revision : Fat grafting to bilateral breasts : Bilateral abdominal dog ear excision in office

Patient with a prior history of implant based breast augmentation for aesthetic purposes. BRCA positive.

Primary Bilateral DIEP after prophylactic mastectomy

Stage 2: Revision of breast reconstruction with fat grafting and excision of abdominal dog ears

Stage 3: Fat grafting to bilateral DIEP breast reconstruction

Bilateral DIEP for patient with a history of right mastectomy and radiation

Patient with a failed attempt at implant reconstruction and nipple reconstruction by another surgeon.

Our Procedures:

Bilateral DIEP, flap with removal bilateral implants

Stage 2: Bilateral breast revision with fat grafting and abdominal donor site revision with vest-over-pants fasciocutaneous flap

Stage 3: Bilateral nipple reconstruction; Bilateral fat grafting, Excision of pigmented hypertrophic scar, left upper breast

Stage 4: Bilateral nipple/areolar tattoos

Patient with a complicated history of prior breast reconstruction on the right with latissimus flap and tissue expander to permanent implant placement performed elsewhere.

Our Procedures:

Bilateral implant removal Bilateral DIEP with bilateral Axogen nerve grafts,

Stage 2: Bilateral breast revision with excision of fat necrosis, fat grafting abdominal donor site revision with vest-over-pants fasciocutaneous flap

Stage 3: Bilateral breast revision with fat grafting to right breast R-180cc and mastopexy to left breast

Patient who underwent immediate left DIEP breast reconstruction after mastectomy.

Revision 9 months later - Right breast reduction for symmetry, left nipple reconstruction, abdominal donor site revision.

Visited 15 years later to provide long term post operative photos!

Patient presented with bilateral tissue expanders placed after non-nipple sparing prophylactic mastectomy performed in another state. done elsewhere. Removed tissue expanders and replaced with bilateral DIEP reconstruction. 2 subsequent stages for fat grafting and abdominal donor site revision and 3-D Nipple tattoo

Primary bilateral DIEP

Stage 2 : Bilateral breast revision with fat grafting and excision of abdominal dog ears

Stage 3: Bilateral breast revision with fat grafting R-140cc, L-160cc and revision of dog ear excision

Bilateral DIEP after prophylactic nipple and skin sparing mastectomy

Stage 2: Revision of bilateral breast reconstruction, donor site revision with excision of scar tissue, fat grafting to right and left upper chest wall

Stage 3: Bilateral breast revision, dog ear revision , fat grafting to right upper chest wall

Primary bilateral DIEP, Flap

Stage 2: Revision of bilateral breast reconstruction; Abdominal donor site revision; Bilateral fat grafting,

Stage 3: Revision of bilateral breast reconstruction; Lipectomy of abdominal donor site; Bilateral fat grafting

Stage 4: Revision of bilateral breast reconstruction; Donor site reconstruction with vest-over-pants fasciocutaneous flap; Bilateral fat grafting,

Stage 5: bilateral breast reconstruction revision, right inframammary fold reconstruction with fasciocutaneous flap, abdominal donor site revision with scar excision and complex closure, right posterior trunk dogear excision, and fat grafting to bilateral upper chest walls

Patient with previous cosmetic augmentation - BRCA2 gene butation positive

Pre- surgery: Bilateral implant removal, nipple delay and abdominal vessel delay

Breast Reconstruction: Primary bilateral DIEP-

Stage 2: Open revision of bilateral breasts with excision of fat necrosis and fat grafting and excision of abdominal scar contractures

Stage 3: Open revision of bilateral breasts with excision of skin paddles, and fat grafting to breasts

Stage 4: fat grafting to breasts R-70cc, L-110cc

Stage 1: : Primary bilateral DIEP with axogen nerve grafts,

Stage 2: Open revision bilateral breasts and excision of abdominal dog ears

Stage 3: Fat grafting 170cc each to bilateral breasts

Right primary direct-to-implant placement

Right implant/Alloderm removal with Bilateral DIEP (left primary) with bilateral Axogen nerve grafts

Open revision of bilateral breasts with fat grafting and excision of abdominal dog ears

Open right breast revision with fat grafting to bilateral breasts

Left breast reconstruction revision with fat grafting

Open revision of left breast with major fat grafting to bilateral breasts

History of breast reconstruction:

Primary bilateral DIEP with axogen nerve grafts, R-340g, L-353g

Stage 2: Open revision bilateral breasts and excision of abdominal dog ears

Stage 3: Fat grafting 170cc each to bilateral breasts

Stage 4: Fat grafting to bilateral breasts R-150cc, L-160c

History of breast reconstruction with abdominal vessel delay

Bilateral DIEP (right delayed, left primary) with bilateral Axogen nerve grafts

open revision of bilateral breasts, excision of abdominal dog ears, excision of abdominal hypertrophic scar

Open revision left breast and fat grafting 90cc to bilateral breasts

Open revision right breast and fat grafting to bilateral breasts

Fat grafting to bilateral breast and upper chest wall (R-200cc, L-160cc)

Bilateral Nipple Areolar Complex 3-D tattooing by specialty artist

Bilateral Gluteal Artery Perforator Flap breast reconstruction after prophylactic mastectomy for strong family history of breast cancer. Nipple and skin sparing mastectomy

Patient presents with failed implant reconstruction. Severe Capsular contracture. Removed implants and converted to natural tissue reconstruction utilizing buttocks - gluteal artery perforator flap

Bilateral breast reconstruction with gluteal artery perforator flaps. GAP flap for breast reconstruction

Patient presents 14 years after initial surgery to have nipple tattoos restored. GAP (buttock)FLAPs recreate breast shape and fullness.

Patient presented to us for Delayed Bilateral Gluteal Artery Perforator Breast Reconstruction - These photos are 14 months after and she has one more revision surgery she would like to have.

She has a very complicated history and multiple failed attempts at breast reconstruction prior to coming to our center. She was diagnosed with left breast stage 111a IDC and had 4 positive lymph nodes. The cancer was treated with neoadjuvant chemo and bilateral mastectomies. Radiation was recommended but declined. She had bilateral TRAM flap reconstruction at the time of her mastectomies. Unfortunately the TRAM flaps were not largely successful so she ended up having tissue expander placement followed by bilateral latissimus flaps. She has had TE to implant exchange and several revision surgeries.

SUCCESSFUL Breast reconstruction with Delayed Bilateral GAP flaps.

History of breast reconstruction: Bilateral implant placement : Bilateral implant removal with SGAP Bilateral buttocks donor site revision with fasciocutaneous advancement flaps : Bilateral breast revision with fat grafting fat grafting to bilateral breasts: Bilateral nipple reconstruction with areolar skin grafts from abdomen and skate flaps

NO PRE OPS - POST OP ONLY. Bilateral GAP (gluteal artery perforator) breast reconstruction

Long term follow up photos of patient who underwent S-GAP Breast reconstruction 10 years prior.

Primary bilateral SGAP

Stage 2: Reconstruction of SGAP donor site with fasciocutaneous pants-over-vest flaps; Stage 3: Revision of bilateral breast reconstruction & Abdominoplasty

Stage 4: Bilateral breast reconstruction revision, Bilateral fat grafting

Stage 5: Bilateral nipple reconstruction; Bilateral breast revision; Fat grafting to left upper chest

Primary Bilateral IGAP flaps

Stage 2: Bilateral nipple reconstruction, revision of bilateral posterior thigh donor defects with posterior thigh flap

Stage 3: Bilateral nipple/areolar tattoos and liposuction of donor site scar

Patient had breast reduction.

This patient had a breast reduction.

Patient had breast reduction.

Patient had breast reduction.

Patient had breast reduction

Patient had breast reduction

Patient had breast reduction