Before and after bilateral prophylactic mastectomies and immediate breast reconstruction in a 28 year old woman who was a carrier of the BRCA gene and whose mother died at an early age of breast cancer. She had her family early and had finished breast feeding.
Her aesthetic goals were to be reconstructed fuller than her deflated postpartum breast volume with a lift of her nipples. Bilateral nipple sparing mastectomies were planned through a breast lift incision. Her nipples and areolas were saved as free grafts, to be reapplied higher on the breast at the end of the surgery.
Smooth, round adjustable saline implants were placed in the space where the breast tissue was, in the “prepectoral” position (on top of the muscle). They were inflated 90% of the way at surgery, with just one inflation of saline solution postoperatively in the office to reach her full size.
Follow up photos are shown 6 weeks after surgery. Her nipples and areolas healed perfectly as free grafts in their lifted position.
Her areolas are currently “effaced” (shiny and stretched out), as is expected when the smooth muscle cells fibers in the areola go to sleep after surgery. The areola tissue incredibly will “wake up” after many months and regain its contractile ability, just like the original areolas!
She has lost erogenous sensation to the nipples because of the mastectomies, but she will also regain light touch sensation to the nipples over time.
She naturally makes hypertrophic scars, as evidenced by her old lumpectomy scar. She is actively doing scar therapy and is so happy to put breast cancer risks behind her. She will eventually have her implant ports removed and likely some liposuction contouring of her “axillary rolls” (back fat /bra roll) in the future.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
