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Before and after delayed breast reconstruction in a 65 year old woman. 30 years before she had a right sided mastectomy for invasive breast cancer without any reconstruction. She was finally ready to have breast reconstruction and wished to be slightly smaller and lifted than her large, heavy and pendulous left breast.

Although she was a candidate for a DIEP flap, she elected to avoid excessive surgery and instead chose a right implant for reconstruction. A smooth, round postoperative adjustable implant was placed in the prepectoral position (on top of her pectoralis major muscle).

The implant was nearly fully inflated at the time of surgery. The implant port was left in place so that we could precisely fine-tune the implant size and volume to best match her left breast, which was reduced and lifted in the same operation.

Over a year later, the right implant was exchanged for a smooth round cohesive silicone gel implant and a right-sided nipple reconstruction was performed by using a left-to-right free nipple graft. The left nipple retains sensation and ends up being around fifty percent smaller. Bilateral areola tattoo completed the procedure for the very best symmetry, and liposuction of her back fat/bra roll helped to optimize her aesthetic outcome.

Follow up photos are shown one month after implant exchange. There is no age limit or time limit after mastectomy or breast cancer reconstruction when women are considering having breast reconstruction. You need to be healthy enough to have surgery, be fully informed about the risks and benefits, alternatives and expected outcomes, and potential complications with any procedure you are seeking. This patient is now asking herself why she waited over 30 years to have this surgery!

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

Dr Karen Horton