Patient 92 Gallery

Before and after bilateral nipple-sparing mastectomies and immediate breast implant reconstruction in a 65-year-old woman.  She previously had undergone several lumpectomies in the past and left breast radiation and recently was diagnosed with recurrent breast cancer.

Given her past experience, she wanted to minimize the amount of surgery she needed for reconstruction as she was planning her retirement and wanted to have surgery before she left work.  Her goals for breast reconstruction included to be smaller and lifted than her current heavy and enlarged breast size.  She was an ideal candidate for nipple preservation via saving her nipples and areolas as free grafts and reapplying to the breast as free grafts, and immediate breast implant reconstruction.

For this surgery, we use smooth round permanent and postoperatively adjustable saline implant that we routinely use for breast reconstruction.  We do not use tissue expanders, rather this adjustable implant that can remain in place permanently if patients don’t wish to have an implant exchange to silicone afterward.

This implant type is inserted in the prepectoral position at the same time as the mastectomies and the remote injection port is left under the skin for at least three months to enable fine-tuning of the implant volume after surgery.  This enables our patients to choose their own final breast size and volume and provides valuable control to woman who are facing breast cancer.

Her implants were fully inflated at the time of surgery, and the skin was closed as for a breast lift.  The nipples and areolas were saved and sutured higher on the breast mound to give her the effect of a subtle and natural looking breast lift.  One additional injection of saline into the implant was done one month after surgery.  She was given the option to have an implant exchange to silicone gel, but she was very satisfied with her results and elated that she could have the implant ports removed in the office under local anesthesia.

Long-term follow up photos are shown 4 years after surgery, with very acceptable results and a happy, comfortable patient who is looking forward to enjoying her retirement!