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This patient underwent bilateral nipple-sparing mastectomy and DIEP flap reconstruction with an immediate-delay technique.  She was diagnosed with an advanced tumor on the right, which would require post-mastectomy radiation.  In the setting of planned radiation, autologous tissue reconstruction is preferred to restore a natural blood supply to the breast, allowing for tissues to recover and soften from radiation injury.  Using the immediate-delay technique, temporary tissue expanders were placed at the time of nipple sparing mastectomy.  She then underwent radiation and chemotherapy.  Once recovered, she had final reconstruction with removal of the expanders and replacement with DIEP flaps from the abdomen.  This improved her abdominal contour and will allow softening of the right breast over time, as the radiated tissues now have a new, healthy blood supply.

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