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Before and After Gallery

Lumpectomy with Perforator Flap

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.

This is a 62-year-old female with upper inner quadrant right breast cancer. We harvest tissue from the back (lateral intercostal artery perforator flap) to fill in this defect and also lift and reshape the right breast to optimize her result. Symmetry is obtained by performing a left breast lift as well. She is shown six months after radiation therapy with no evidence of right breast deformity despite the removal of extensive breast cancer.

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This is a 60-year-old female who has left breast cancer for which she desires a breast lift and augmentation. We proceed with a left breast lumpectomy and lift with volume supplementation with flap tissue from the back. On the right side, to obtain symmetry, we also lift the breast and borrow tissue from the back to assist with volume supplementation. This approach of augmenting the breast at the time of breast conservation with your own tissue was first described by Dr. Schwarz in 2018. Her donor sites in the bra line heal nicely.

This is a 52-year-old female with stage one left breast cancer who desires a breast augmentation and lift at the time of her partial mastectomy. We proceed with a left partial mastectomy, lift, and volume supplementation with a flap from the back. On the right side, we perform a similar operation, lifting the right breast and supplementing volume with tissue from the back. She is shown six months after she completes radiation therapy. This approach of lifting the breast and augmenting its volume with tissue from the back at the time of partial mastectomy was first described by Dr. Schwartz in 2018.

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This is a 51-year-old female with a malignant phyllodes tumor. She undergoes an extensive left partial mastectomy including skin and is reconstructed with a muscle-sparing latissimus dorsi flap from the back to replace both volume and skin. She is shown six months after surgery.