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This patient presented with breast cancer of her left breast and desired bilateral mastectomy.  She had undergone prior breast augmentation with implants and abdominal liposuction resultant in lower abdominal deformity.  She desired autologous reconstruction to maintain roughly the same volume.  A staged reconstruction starting with lumpectomy and breast lift were performed.  She then underwent mastectomy and tissue expander insertion.  This was finally converted to four flap breast reconstruction utilizing a PAP flap (taken from the thigh) and DIEP flap (taken from the remaining available abdominal tissue).  A small implant (<190 cc) was placed under the entire construct for added projection.  She is just 4 weeks out from her final stage of surgery here.
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