BRCA1 Prophylactic Mastectomy Recon with DIEP/SIEA Flaps in The Woodlands, TX

This is a delightful woman with a family history of breast and ovarian cancers. She tested positive for a mutation in the BRCA1 gene, which greatly increases her lifetime risk of developing breast cancer. The patient decided to have risk reduction surgery with bilateral skin-sparing prophylactic mastectomies. Notably, she had prior cosmetic breast augmentation with saline implants. However, she preferred tissue-based reconstruction using her lower abdominal tissue to avoid future surgeries for implant maintenance. She also desired more natural feeling reconstructed breasts. In the same surgery as her mastectomy, she had immediate breast reconstruction with an SIEA flap on the right and DIEP flap on the left (the type of flap used was determined by the vascular anatomy encountered in surgery). In addition, her DIEP and SIEA flaps were innervated with a cutaneous sensory nerve using a nerve graft; the ReSensation technique was used. The patient had 1 revision procedure 3 months later for fat grafting and scar revision to optimize her final outcome. She chose to have nipple areola tattooing without formal nipple mound reconstruction.