Before and after bilateral prophylactic nipple sparing mastectomies and implant reconstruction in a 37 year old BRCA gene positive woman. She had submuscular implants and did not like the way they sat so high on her chest. She wanted increased fullness but for her implants to not sit up so high.
In submuscular breast augmentation, the pectoralis major muscle tends to pull breast implants up high due to the muscle vector – consequently, implants sit in a “non-anatomic position” very high up, under the collar bone.
Nipple sparing mastectomies were done through an incision hidden in the fold under the breast. Smooth round adjustable saline filled implants were placed prepectorally, in the space above the muscle where the breast tissue was.
The implants were filled up completely to replace the lost volume. Just one postoperative inflation was done at two weeks after surgery to increase the fullness of the reconstruction. At the time of implant port removal, the saline breast implants were replaced with smooth round silicone gel.
Follow up photos are shown 3 months after implant exchange, one year after her mastectomies. She likes her reconstructed breasts better than her original ones. Her sensation is starting to return naturally and slowly, including to her nipples!
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
