Before and after bilateral breast implant reconstruction revision from under-the-muscle implants to on-top of the muscle (prepectoral) implants in a 50-year-old BRCA+ breast cancer survivor. She experienced tightness and a pulling sensation, primarily on her right dominant side. She had lost her right nipple after the mastectomy due to a lack of blood supply – she had only an areola circle on the right side, and a full-sized nipple on the left.
Her revision involved removal of the previously placed implants, reconstruction of her pectoralis major muscles to the chest wall, insertion of new silicone gel breast implants, and right nipple reconstruction using a free graft from the left (the “nipple sharing” technique). Fat grafting was done to both breasts in order to try to provide additional padding over her implants and conceal implant ripples (or wrinkles).
Follow up photos are shown 6 months after surgery. She still has some mild rippling due to the very thin mastectomy skin flaps. Unfortunately, fat grafting to mastectomy skin flaps is not magic. Most of the fat does not survive and usually goes away within three months. Her donor site (the abdomen and flanks) however looks fantastic!
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
