Before and after bilateral nipple sparing mastectomy and immediate implant reconstruction in a 45 year old woman. She had a left sided breast cancer and elected to have mastectomies on both sides. She was very athletic and did not have enough fat for a flap reconstruction.
Her mastectomies were performed by incisions hidden in the inframammary fold (the fold under the breast). Her nipples and areolas were saved. Smooth, round permanent and postoperatively adjustable implants were placed and filled nearly 100% full at the time of her mastectomies. She required postoperative chemotherapy followed by radiation therapy to the left breast.
She waited six months after radiation was complete to have her implant ports removed and the adjustable saline implants exchanged for silicone. She was offered a lift of her nipples at the same time but she did not want additional scars on her breasts and felt she looked pretty much like before she had breast cancer (true!).
Liposuction of the axillary rolls (armpit fat) was done at her second stage procedure to debulk this prominent fat, which persisted despite how fit she was and how many marathons she ran.
Follow up photos are shown over a year after her mastectomies and one month after implant exchange and axillary roll liposuction. She is back exercising without any restrictions and she loves NOT having the under the muscle flexion deformity and tightness that so many women at her support group complain of! She looks natural, and her armpit appearance is greatly improved.
Implant reconstruction certainly IS possible after radiation therapy. Implants do not need to always be under the muscle and ADM (acellular dermal matrix) is very rarely used in my practice. To learn more, visit the immediate breast reconstruction web page and related blog posts.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
