Before and after bilateral breast reconstruction revision in a 43-year-old breast cancer survivor. Her totally submuscular implants were painful, tight and unsightly, limiting her from exercising and lifting her children.
Radiation had caused permanent damage to her left chest wall and breast skin, as expected. She did not want a flap reconstruction but was relieved that implants were still an option for her, despite her history of radiation.
Her revision involved removal of her saline-filled implants, replacement of her pectoralis major muscles to the chest wall, and insertion of new smooth round silicone gel breast implants on top of the muscle, in the prepectoral position. Her chemotherapy port was removed, and liposuction debulked excess fat from her armpits and bra rolls. Nipple reconstruction was performed using the local flap technique, and medical tattoo created two new areolar circles.
Long-term follow up photos are shown 4 years after surgery. The left breast is still sitting up a little higher as expected, due to radiation effects, but this is not bothersome to her. The animation deformity is gone, she has better symmetry and is able to play tennis, golf and lift both of her kids at once.
Revision surgery after breast cancer reconstruction is possible at any time in the future, as long as a patient is healthy enough to undergo surgery and the patient has full informed consent about surgery – including the risks and benefits of the planned procedure, the alternatives to surgery, expected outcome, and potential complications. Radiation indeed makes the procedure more complicated, but our experience and techniques help ensure a successful and beautiful outcome.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
