Before and after bilateral breast revision in a 60 year old breast cancer survivor. 30 years previously she had undergone bilateral skin sparing mastectomies and implant reconstructions with implants under her pectoralis major muscles. She stated her implants had never felt right, and that they had migrated into her armpits over the years from chronic muscle movement such as when she swam.
She had a past attempt at nipple reconstruction that did not look normal. She wanted to mostly FEEL better, to alleviate her muscle strain from any upper body movement. She was amazed that anything could be done to help her LOOK better too! She wanted to continue to be able to not wear a bra and to have the smallest breasts that looked natural for her.
Unfortunately in general – but fortunately for my patients – a large proportion of my practice focuses on breast revision surgery. If a patient is unhappy with the outcome of their cosmetic or reconstructive breast surgery(ies), then we can usually offer them a solution to help them look and feel better! For this patient, the old implants were removed, both of which were old ruptured second generation silicone implants placed at her original surgery. Surrounding scar tissue was removed in a total capsulectomy.
Her pectoralis major muscles were returned to her chest wall and a new implant space was created on top of the muscle. This is the standard of care for all our patients – some academic publications are now promoting this technique as “pre-pectoral” breast reconstruction – although it is certainly not new! New smooth round cohesive silicone gel breast implants were placed under her breast skin. Liposuction of the sides of her breasts helped to improve the contour of her lateral chest wall. Tattoo was used to create new nipples and areolas.
Follow up photos are shown 6 weeks after surgery. Her “animation deformity”, visible when she flexes her muscles, is gone. Her pain and discomfort was gone immediately when she awoke from surgery. Her nipple and areola bright color will fade to a more natural hue over the next several months. Her incisions under her breasts are pink as expected, and the swelling at the sides of her breasts is starting to resolve.
She is amazed that for the first time after having breast cancer over 30 years ago, that when she puts on her swimsuit or undresses, the first thought she has is no longer “I had breast cancer”. She is finally getting on with her life!
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
