Before and after bilateral nipple-sparing mastectomies and immediate prepectoral breast implant reconstruction in a 60-year-old woman. She previously had a right lumpectomy and radiation therapy for breast cancer at age 38 and when her cancer recurred, genetic testing revealed she was a carrier of BRCA gene. Therefore, she opted for a double mastectomy to further reduce her risk of future cancers.
Her breast tissue was removed through an incision under her breasts. At the same procedure, smooth round saline-filled breast implants were placed on top of the muscle, in the same space where the breast tissue was.
This patient’s goal was to be reconstructed larger than her natural breast size. Each implant was inflated to a total of 200 cc at the time of her surgery – her breast tissue weighed just 47 and 97 grams. When estimating how much we will fill an implant at the time of immediate breast reconstruction, we consider a one-to-one ratio of the weight of breast tissue removed to the volume of implant fill.
Early follow up photos are shown 2 weeks after surgery. She has started implant massage and is relieved to get her Pathology report, which showed clear margins and normal lymph nodes – hence, no chemotherapy or radiation to the other breast.
Her final procedure will involve replacement of her saline-filled breast implants with silicone implants once she is sure that she is happy with the volume, removal of the implant ports and liposuction of the axillary rolls. She is planning this procedure in six months to allow her to resume all her normal activities first and “get her life back” before having surgery again. There is never a rush to perform breast revisions, especially when other surgeries are on the cancer’s schedule!
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
