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Before and after left skin sparing mastectomy and immediate implant reconstruction in a 52 year old woman with breast cancer. She was an excellent candidate for a breast reduction, and her goal was to be smaller than her current oversized and pendulous breasts. She required chemotherapy postoperatively. She was a candidate for a flap but she opted for an implant to return to work as soon as possible and have the minimal amount of scars.

A mastectomy was planned through a breast reduction pattern on the left. Her nipple and areola could not be saved due to tumor involvement. A smooth, round permanent and postoperatively adjustable implant was placed directly where the breast tissue was removed (on top of the muscle) and was fully inflated during surgery. A right sided breast reduction was performed at the same procedure for symmetry.

Nipple and areola reconstruction was performed six months later at the time of port removal on the left side. The left nipple was reconstructed using the local flap technique. At the same outpatient procedure, both areolas were tattooed for the best symmetry of color, hue and intensity.

She kept her saline implant in place instead of switching to silicone as she was happy with her reconstruction and did not want any more surgery! This is a distinct advantage of using adjustable permanent saline implants – they do not need to be removed and replaced, like tissue expanders.

Follow up photos are shown 8 years after her mastectomy and breast reduction, and 7 years after nipple and areola reconstruction. Her tattoo has held up, and she still has good symmetry of her breasts without any complications.

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

Dr Karen Horton