Before and after left delayed implant reconstruction in a 45-year-old “triple negative” breast cancer survivor. Her left breast implant reconstruction had failed due to acute infection after radiation treatments. She was not a candidate for a free flap reconstruction due to a paucity of donor site tissue in her abdomen and inner thighs. She felt her right breast implant was too big; she was looking for a more natural looking and proportional result.
Her left breast reconstruction involved a pedicled latissimus dorsi muscle flap to bring new healthy tissue to the left chest with insertion of a prepectoral new implant on top of the muscle. In addition, free fat grafting and acellular dermal matrix was added under the left upper pole to provide additional padding to the thin, radiated breast skin.
For the right breast reconstruction, her submuscular implant was converted to a new implant in the prepectoral position, on top of the muscle. Her pectoralis major muscle was reconstructed and reattached to the ribs and the sternum.
A secondary procedure created new nipple prominences using the local flap technique. Medical tattoo created new areolar circles, and liposuction removed excess fat from her armpits and bra rolls (the axillary rolls). The last set of images shows her latissimus dorsi (LD) flap donor site on her back.
Long term follow up photos are shown 7 years after surgery. Unfortunately, her aggressive breast cancer recurred and metastasized, requiring additional chemotherapy – hence the new chemotherapy port on her right chest. Tragically, she ultimately succumbed to this devastating disease but lived a full twenty years after her original breast cancer diagnosis with dignity, improved breast symmetry and a restored body image.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
