TRAM AO3853

55 yo who had previously lost 80 lbs. from gastric bypass surgery developed right breast cancer treated with lumpectomy. The surgical margins were positive and the patient elected to proceed with a right completion mastectomy and prophylactic left mastectomy. Breast reconstruction was accomplished at the same time with a left DIEP free flap and a right muscle sparing free TRAM flap. Microvascular anastomoses were to the internal mammary vessels. Nipple areolar reconstruction was performed 6 months later. Postoperative photos are taken 1 year following her mastectomies.