Before and after bilateral breast implant reconstruction in a 49-year-old woman with left breast cancer. Her existing submuscular implants had significant animation deformity and sat high on her chest, causing an unnatural rounded upper pole contour. The scar beneath her areola from the original breast augmentation was indented and contributed to an unnatural appearance.
She had completed neoadjuvant chemotherapy to shrink her tumor prior to surgery. Despite being given the option to just have surgery on one side, she elected to have a right mastectomy as well and undergo bilateral prepectoral implant reconstruction.
When breast implants are placed on top of the muscle, there is no animation deformity, no “double bubble”, minimal pain or tightness sensation and a lower risk of chronic implant folding and consequent rupture. Our practice has only offered implants on top of the muscle since 2007, and our patients are very happy with their decision to preserve pectoralis major muscle strength, function and their chest wall anatomy.
After surgery, she required left chest wall radiation. Follow up photos are shown 9 months after completion of radiation and 2 months after implant exchange from adjustable saline implants to silicone.
It is anticipated that her left breast reconstruction will shrink a small amount and that the left implant may sit up slightly higher than the right non-radiated side. This is an evitable consequence of radiation that cannot be avoided, regardless of how good things look after surgery. A revision procedure could be considered a year or two after radiation is completed, when all radiation effects are complete and the final result can be evaluated.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
