Patient 1 Gallery

Before and after left delayed breast implant reconstruction in a 66-year-old breast cancer survivor. She had previously undergone nipple-sparing mastectomy and insertion of a tissue expander that became infected and required removal. She waited a full year to allow edema (surgical swelling due to past surgery and infection) to gradually resolve.

She dreaded going through the painful and lengthy tissue expansion process once again – she was in disbelief when she learned that not only was tissue expansion unnecessary, she also did not need to have the device placed under her chest muscle.

The inframammary fold incision was used to open the mastectomy space and recreate the pocket where her breast formerly was, on top of the muscle, in the “prepectoral” position. Intraoperative sizing with a temporary saline-filled sizer helped to determine which volume, projection and width would best match her right breast, which she did not want to modify.

Explantation does not cause permanent skin shrinkage if an implant is reinserted – the contracted breast will open up again once a new implant is placed and the former breast envelope can be recreated.

A permanent smooth round silicone gel breast implant was placed on top of the muscle to reconstruct her breast. Liposuction was used to permanently remove fat from her armpit area, known as the axillary rolls.

Follow up photos are shown 5 months after surgery. Mild rippling (visible folds of the implant) can be seen at the upper pole of her breast. Nowadays, the breast implants available for reconstruction have less rippling and an even nicer aesthetic result. Fat grafting is also an option now to try to add some padding to a thin mastectomy skin flap.

She wishes she had been given this option for reconstruction when she was diagnosed with breast cancer, but she considers the infection and need for explantation a blessing as it allowed her to further research her reconstruction options.