Before and after breast revision in a 66 year old woman. She previously had undergone a left skin sparing mastectomy with tissue expander and implant reconstruction under the muscle. Her right breast had changed after menopause and drooped more than the reconstructed breast, creating asymmetry. Her goal was “to have a matching pair”.
The old left breast implant was removed, her pectoralis major muscle was returned to the chest wall and a new more highly cohesive silicone gel breast implant was placed on top of the muscle, in the prepectoral position.
Her right breast was lifted and reshaped. A piece of the right nipple was transplanted to the left breast reconstruction as a free nipple graft to reconstruct the left nipple. This is called “nipple sharing”. Her left areola was reconstructed by tattoo.
To complete her revision, liposuction permanently removed fat from her axillary rolls (armpit regions) and the back fat/bra roll area.
Follow up photos are shown 6 months after surgery. She has greatly improved symmetry and she feels “less like a breast cancer patient” when she is changing at the gym or undressing in front of the mirror.
Her right areola nerves are still waking up. This is seen by the slightly increased diameter of her right areola as compared to the left. The areola has smooth muscle cell fibers that create a change in size and shape of the areola (constriction) upon touch or cold.
These nerves go to sleep after most surgeries of the breast, but they will wake up and recover completely over time. Her right areola will regain its contractile ability to better match the left side.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
