Case-9435 Gallery

Before and after bilateral prophylactic nipple sparing mastectomies and immediate breast reconstruction using smooth round adjustable saline implants in a 52 year old BRCA gene positive woman. She wished to be reconstructed fuller than her preoperative breast size; we encouraged her to consider this surgery and the reconstruction her “Mommy Makeover”!

Implants were placed on top of the muscle, in the natural breast space, which just makes sense! This is also known as “pre-pectoral reconstruction”. The best thing about this method of breast reconstruction is that the PATIENT gets to choose how full she wants to be by inflation of the implants to a volume that she is comfortable with. Incisions for nipple sparing mastectomy are always hidden in the breast fold.

Implants are filled 60% to 80% intraoperatively at the time of the mastectomies. Just two postoperative inflations were required in the office and she was fully inflated and reconstructed at 3 weeks postoperatively. After that time, the implant volume can be added or subtracted and patients can “try out” different breast sizes in their own body to determine exactly what result is the best fit for them!

This type of implant reconstruction provides the most natural cosmetic results and preserves the natural shape of the breast, without pectoralis muscle tightness, discomfort or the “flexion deformity” that occurs whenever implants are placed under the muscle. No ADM or other synthetic products were used.

Follow up photos are shown at 3 years after surgery. She underwent removal of the implant ports and exchange of the saline implants for smooth round cohesive silicone gel implants at 6 months after the initial reconstruction. These newest 7th generation breast implants provide the most natural look and feel to the final reconstruction. She is now coming back for yearly follow ups and has got on with her life, greatly reducing her change of developing breast cancer.