Before and after bilateral nipple sparing mastectomies and immediate single stage prepectoral implant reconstructions in a 61 year old woman. Her breasts had always been small, and most of her volume was lost after breast feeding, menopause and weight loss. She expressed that she felt like she had a male chest. Her aesthetic goal was to be reconstructed fuller than her natural breast size but to still look natural and proportional to her body frame.
Bilateral nipple sparing mastectomies were performed through an inframammary fold incision, hidden in the fold of the breast. Smooth round adjustable implants were placed and fully inflated at the time of surgery.
She traveled a lot for work and returned to full activities one month postoperatively. Six months later, she had her implant ports removed and chose to keep her saline filled implants. Long term follow up photos are shown at 5 years after surgery.
Switching out saline filled implants used for breast reconstruction for silicone gel is not always necessary, as shown in this case. The patient knows she is a candidate for implant exchange in the future if she wishes, and also to switch to a tissue based reconstruction such as the DIEP flap.
She has gained weight over the last several years and now finally has enough tissue for a flap from her lower abdomen. Thanks to California Governor Arnold Schwarzenegger, she is entitled by law not only to her preferred reconstruction choice on the cancer side and the other breast, but any revision as necessary down the road. But for now, she is happy just the way she is.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
