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Before and after breast reconstruction in a 68 year old woman with left breast cancer. She had previously had a breast reduction, as evidenced by her preoperative scars. She had a large tumor involving her left nipple and areola, and required a large lumpectomy, sentinel lymph node biopsy and postoperative radiation therapy and chemotherapy. She did not want a mastectomy or and implant. She wanted to minimize surgery, maintaining her body and symmetry of her breasts.

A combined procedure with the breast surgeon involved a left lumpectomy and “local tissue rearrangement” of her remaining breast tissue. Her left nipple and areola was removed together with the breast cancer. Reconstruction of her left breast was via a breast lift, which rearranged and reshaped her remaining left breast tissue into a lifted contour.

Her left nipple was reconstructed using a free nipple graft from the right side. A right breast reduction and lift created symmetry with the reconstructed breast. The right breast was reduced slightly more than the left side, to take into account expected mild shrinkage of the left breast after radiation therapy.

The left areola was reconstructed using medical tattoo, and the right areola was also tattooed to achieve symmetry. Note the color is darker than her original areola color, as per her wishes. Medical tattoo gradually fades over the years to a more natural intensity.

Postoperatively, she completed chemotherapy and radiation therapy to her left chest wall. Her left breast reconstruction shrunk very subtly over a year following radiation. Long term follow up photos are shown four years after surgery and radiation therapy. At age 72, she has maintained symmetry and she “does not feel like a cancer patient”. And she loves not needing to wear a bra!

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

Dr Karen Horton