Before and after breast reconstruction revision in a 55 year old breast cancer survivor. At age 40, she had bilateral mastectomies, chemotherapy and high-energy radiation therapy with resultant left arm lymphedema.
She previously had bilateral TRAM flap reconstructions (a procedure that sacrifices the rectus abdominis muscle and overlying fascia, creating weakness and a lower abdominal bulge) elsewhere. She was looking for “any improvement possible” to her results.
Part of her misshapenness resulted from significant axillary fat that had developed with menopause and weight gain. Her past nipple and areola reconstructions had faded over the past 15 years. She wished to have the minimal amount of surgery and declined repair of her abdominal bulge resulting from TRAM flap surgery, as she had already had many abdominal surgeries with complications in the past.
Bilateral breast revision included aggressive liposuction of her axillary rolls to de-fat these areas and improve her armpit contour. Since liposuction is relatively superficial, away from deep lymph nodes, she did not have increased risk of further lymphedema. She was allowed to wear her compression sleeve during surgery and continue formal lymphedema therapy days after surgery.
Additional liposuction of her chest wall in the area of the TRAM flap muscle pedicle helped to better define the bottom of her breast reconstructions and created better symmetry.
Re-tattoo of her prior nipple and areola reconstructions brightened them and provided improved definition. She declined free fat grafting or other major revisions. She was satisfied with her results, and now wears tank tops to work without self-consciousness!
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
