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Before and after breast revision in a 66 year old woman who had previously undergone a left mastectomy and TRAM flap breast reconstruction with a right balancing breast lift. Over the last 10 years, she had gained some weight and noted a difference in her breast size. The past areola tattoo on the left had faded.

A breast revision involved liposuction of the right breast to subtly reduce its volume, free fat grafting to the left breast reconstruction to slightly increase its volume and fill in a divot on the side of her breast reconstruction, and retattoo of the left areola reconstruction.

In general, tattoo of both areolas is usually recommended to ensure the best possible symmetry of areola pigment, hue and color intensity, but the patient declined.

Follow up images are shown at 4 months after surgery. At three months, we can accurately assess the percentage survival or “take” of the transplanted fat cells after free fat grafting. The resultant improved symmetry should be permanent. The bright tattoo will fade gradually over the next year.

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after
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*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.

Dr Karen Horton