Procedure: Procedure: Latissimus dorsi and implant

This 55-year old woman presented 2 years after left mastectomy, chemotherapy, and radiation therapy for breast cancer. She complained about feeling lopsided. Additionally, the lack of left breast was a constant reminder of her disease. Although the patient was apprehensive about having more surgery, she was offered a staged reconstruction of the breast combined with a symmetry procedure on the right side. In the first stage, the left latissimus dorsi was transferred to reconstruct the left breast. At the same time, a tissue expander was placed under the transferred flap to further recreate the missing volume. The second stage consisted of replacement of the left breast tissue expander for 525 ml silicone implant coupled with large volume fat grafting of 190 ml to the upper pole of the left breast. The right breast was reduced by 300 grams of tissue and lifted. Interestingly, the left nipple-areola complex was reconstructed using a local flap and skin graft derived form the right breast skin that was to be discarded during the reduction. The stages of reconstruction were conducted 4 months apart. The patient is very pleased with her result and being able to feel whole again.