Reconstruction after a recurrence, when the usual options are gone

A substantial part of this practice is caring for patients who had their reconstruction somewhere else and need it revised or rebuilt.

This patient had a complex history: a left mastectomy and reconstruction with a DIEP flap, then a recurrence, treated with resection and radiation. She came to the practice with significant asymmetry, a contracted implant on the left, and very few donor sites left.

The abdomen had already been used, and she is very thin, so the usual alternatives were limited. The reconstruction was carried out using stacked PAP flaps combined with implant-based reconstruction.

Having the full range of flap options available is what makes a case like this solvable.