Before and after bilateral nipple sparing mastectomies and immediate breast implant reconstruction in a 46 year old woman. She had previously had a lumpectomy on the right with positive margins. She elected to have bilateral mastectomies given her age. She was a candidate for a flap such as the DIEP flap or a TUG flap but she chose implants. Her goal was to be reconstructed slightly fuller than her preoperative size and to have better symmetry after surgery.
Her breast tissue was removed by a scar hidden under her breast in the inframammary fold. Her nipples were saved and smooth, round adjustable saline implants were placed in the space where the breast tissue was, on top of the muscle. This is called pre-pectoral breast reconstruction in the literature.
Her implants were inflated 80% of the way at the time of surgery; two inflations of saline were performed in the office at one week and two weeks after surgery. She returned to work at one month without restrictions and continued to play golf. Not having her implants under her muscles, she never had any of the pain described by her friends who had tissue expander-implant reconstruction under the muscle!
She chose to exchange her saline implants for silicone gel implants at three months after her mastectomy. This was a simple outpatient procedure. Follow up photos are shown one month after implant exchange. She has much better symmetry of her breasts, and for her, “breast cancer is just a memory now!”
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
