Before and after right nipple sparing mastectomy and immediate prepectoral (on top of the muscle) implant reconstruction in a 43 year old woman with aggressive breast cancer. She noticed deflation of her breasts after having kids and wanted to be reconstructed fuller than her current breast size.
A balancing augmentation was planned on the left side, also on top of the muscle in the subglandular position. For each breast, a smooth round permanent and postoperatively adjustable implant was placed and filled to its current volume at the time of the mastectomy.
No tissue expansion was required, no injections needed in the office and pain was minimal after surgery since her pectoralis major muscles were not being stretched out!
After surgery, she completed radiation therapy and a long course of chemotherapy. Her injection ports for the implants were kept in place during this time to allow for adjustment of the implant volume if needed by maintaining the ability to add or subtract saline as needed.
Follow up photos are shown six months after completion of radiation. Her right radiated breast is sitting slightly higher than the other side and the skin is still darker in color. She gained some weight during chemotherapy, causing her left breast to increase in volume.
We will wait until the radiation changes are complete (a year at least) and her weight normalizes/stabilizes before removing the breast implant ports and/or exchanging her saline implants to silicone.
Reasons to switch to silicone including implant rippling with saline devices and the goal of a more natural look and feel to the implants. In our office, most patients choose to switch to silicone, but the adjustable saline implants are indeed permanent devices and many women choose to minimize additional surgery and simply have their ports removed in the office under local anesthetic.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
