Case-10157 Gallery

Before and after bilateral nipple sparing mastectomy and immediate implant reconstruction in a 41 year old woman with invasive breast cancer.  Prior to this procedure, she underwent neoadjuvant chemotherapy to shrink the tumor.  Her chemotherapy port can be seen under the skin of her left chest.  She had previously had a breast reduction, and she wished to be reconstructed slightly smaller than her preoperative size.

Her breast tissue was removed by way of the old scar under her breasts.  Her nipples were already in a lifted position and were preserved.  A smooth, round adjustable saline breast implant was placed on top of the muscle and filled nearly all the way at the time of her reconstruction.  This is called prepectoral or subcutaneous implant reconstruction.  No ADM (acellular dermal matrix) or any other mesh or synthetic or biological product was used. 

She next underwent radiation therapy to her right breast.  The implant ports (located under the skin to the sides of her breast folds) were left in place during this time so that the volume could be modified if needed.  She finished her radiation and then waited 6 months before her implant exchange from saline to silicone and port removal. 

Follow up photos are shown just 5 weeks after bilateral implant exchange to a smooth, round cohesive gummy bear breast implant on each side.  The radiation caused her right breast reconstruction to shrink slightly, but did not injure her reconstruction in any way.  The radiated implant remains soft and mobile. 

At this second (and last) procedure, for the very best symmetry, the left breast vertical incision under the nipple was redone to tighten the left breast skin as well.  This incision is still healing and her left areola will assume a more normal contour over the next month. 

She is going back to work and has resumed full exercise.  Since her implants are NOT under the muscle, she can golf, lift weights, do yoga and do any activity she wants without the frustrating flexion deformity that is so common with submuscular implants. 

She can now move on with her life, with breast cancer in her rear mirror.  She is very pleased with her natural reconstruction result!