Patient 4 Gallery

Before and after bilateral nipple sparing mastectomy and immediate implant reconstruction in a 57 year old woman with a right sided breast cancer. She chose to have a left sided prophylactic mastectomy at the same time. Although she had a dear friend who had the DIEP flap in my practice, she did not have enough lower abdominal skin and fat for a flap. Implants were the best option for her.

She carefully researched her options and learned that she did not want to have implants under the muscle. She wanted a natural looking result that would allow her to return to full activities as soon as possible, with the least amount of pain and no long term limitations on her physical function.

Bilateral nipple sparing mastectomies removed all her breast tissue. A specimen was sent from underneath her nipples to confirm that there were no abnormal cells there. Smooth, round, permanent and postoperatively adjustable saline implants were placed at time of mastectomy and filled to the same volume as her breast tissue was. Implants were placed on top of the muscle, in the pre-pectoral position, as is the standard for all my patients.

She spent two nights in the hospital and had her drains removed in one week. One additional saline inflation was done by way of the port under her skin just under her breast fold to complete her reconstruction at two weeks. She returned to her home state to continue her recovery.

Follow up photos are shown at 3 months after surgery. Note the absence of muscle flexion when she pushes her hands on her hips to flex her pectoralis major muscles. She wished to be reconstructed slightly fuller than her original postpartum and postmenopausal breast volume.

She plans to keep these implants so that she can travel and live life for a while! She will have her implant ports removed and will likely change her implants from saline to the newest silicone gel implants around one year, or whenever she feels like having a short outpatient procedure. There is no rush!