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Before and After Gallery

Lumpectomy with Perforator Flap

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77 year old female with extensive left breast cancer requires a perforator flap and lift to save her left breast. Doctor Schwartz is able to clear her cancer and avoid a mastectomy by combining a flap and lift, an approach he first described in 2018. Several other surgeons had told her that she required a mastectomy.

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51 year old female with a large upper inner quadrant left breast cancer. This is a notoriously challenging area of the breast to reconstruct and often leaves significant deformity.  She desires breast conservation. We combined a Perforator flap from beneath her breast and a special temporary implant (Biozorb) to reconstruct her defect and leave her without any deformity. The Biozorb implant both facilitates delivery of radiation and helps to reconstruct lumpectomy defects. Doctor Schwartz was the first surgeon to combine the Biozorb and perforator flap to improve the aesthetic results after lumpectomy surgery.  He described this approach and published his results in April 2023.

This is a 47-year-old female with right breast cancer that is invading the nipple. She undergoes resection of her nipple and areola and underlying breast tissue with replacement of volume with a flap from the back. The tissue from the back also supplies skin to reconstruct the areola. The right nipple is reconstructed by sharing a portion of the left nipple and grafting it to the new areolar skin. This procedure of nipple sharing after breast conservation was first described by Dr. Schwarz in 2021.

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This is a 49-year-old female with central right breast cancer that is invading the nipple and the areola. She undergoes a right partial mastectomy to remove her nipple areola complex and underlying breast tissue with immediate volume and skin replacement with a flap from the back. The new nipple is immediately reconstructed on the skin from the back flap. 

This is a 52-year-old female with an upper inner quadrant right breast cancer. This is a notoriously difficult position of the breast to reconstruct with a high rate of deformity after breast conservation and radiation therapy. After resecting the tumor through the crease at the bottom of the breast, tissue is borrowed from below the breast (medial intercostal artery perforator flap) and rotated into the upper inner quadrant to fill the defect and avoid deformity after surgery. She is shown here six months after the completion of radiotherapy with no evidence of deformity. There are no obvious scars on her breast after surgery.

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This is a 52-year-old female with extensive right breast cancer that other surgeons have recommended mastectomy. She refuses mastectomy and comes to Dr. Schwartz for breast conservation. We resect most of the outer quadrant of her right breast and fill this with tissue from the back (lateral intercostal artery perforator flap) and also lift the right breast to improve its shape. We perform a left breast lift to obtain good symmetry. This approach of combining volume replacement from the back and reshaping the breast in one operation was first described by Dr. Schwartz in 2018. She is shown six months after radiation therapy. Her scar in the bra line is also showed in the lateral position.

66-year-old female with extensive left breast cancer involving her nipple and areola.   She desires breast conservation. Dr. Schwartz removes her left breast cancer, lifts both breasts, reconstructs her left nipple, and brings tissue in from the back to replace the tissue removed from the left breast.  This is all performed in one surgery.  There is no other surgeon in the United States that performs these types of oncoplastic procedures.  These approaches were invented and published by Dr. Schwartz.

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59-year-old female with bilateral breast cancer.  She is shown 6 months after bilateral lumpectomy and radiation therapy.  While the right breast cancer is small and requires just a simple surgery, her left breast cancer measures 6 cm and invades the skin.  Dr. Schwartz uses a flap from the back to replace both her left breast skin and tissue volume.

49-year-old female with extensive left breast cancer refusing mastectomy. We immediately reconstruct her left breast with a modified lateral intercostal artery perforator flap allowing her to save her breast.  This modified flap was first described by Dr. Schwartz allowing him to recruit additional tissue to reconstruct the most challenging defects. She is shown after radiation therapy with no evidence of deformity.  She has some additional scars along her side chest wall where Dr. Schwartz recruited tissue to reconstruct her breast.

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39-year-old female with a large left breast cancer and small breasts.  She desires breast conservation.  Dr. Schwartz combines a lift procedure with a flap from the side (lateral intercostal artery perforator flap) to save her breast. He also lifts the right breast for symmetry.  The tissue he recruits comes from her side where you see the additional scar.  Dr. Schwartz first described combining a lift and flap (the patient’s own tissue coming from outside the breast) to address the most challenging cases of breast conservation. 

63-year-old female with a large right breast cancer and small breast.  The patient desires breast conservation.  Dr. Schwartz removes her cancer and replaces the volume removed with excess tissue from below and to the side of her breast, hiding her scars.  She requires radiation therapy and is shown 12 months after the completion of the therapy.

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66-year-old female with extensive right breast cancer who desires breast conservation.   Dr. Schwartz uses excess tissue from her side to replace the large defect created when removing her right breast cancer.  She is shown 3 months after surgery.  The scar from the perforator flap is well healed on the side of her breast.  Dr. Schwartz is one of a handful of surgeons in the US who is skilled at using perforator flaps to facilitate breast conservation. 

52-year-old female with advanced right breast cancer who desires breast conservation. Dr. Schwartz combines a breast lift with a flap (patients own tissue) from the back to save her right breast. He also lifts her left breast flap for symmetry. Dr Schwartz first described using a lift and flaps together to address the most challenging cases of breast conservation.

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