Before and after bilateral prophylactic nipple-sparing mastectomies and immediate implant reconstruction in a 30-year-old BRCA gene-positive woman who had a very significant family history of early breast cancer. She sought risk-reduction and wanted to have a fuller, rounder and lifted breast reconstruction outcome.
Bilateral nipple-sparing mastectomies were performed using a breast reduction and lift pattern. Because she had significant “ptosis” of her breasts (droop, where the nipples are low), her nipples were preserved as free nipple-areolar grafts in order to ensure they healed well without wound healing difficulties from the long distance blood vessels would need to travel to reach them.
At the same time as the mastectomies, smooth round permanent postoperatively adjustable saline-filled breast implants were placed on top of the chest muscle, in the prepectoral position. They were inflated all the way at the time of surgery, so that she had a larger breast size than before surgery.
After surgery, she had her first baby and used breast milk from a local breast milk bank to feed her baby together with traditional formula. She chose to wait over a year and a half to plan her final procedure – namely, port removal and implant exchange.
Most patients choose to switch from saline implants to silicone for the most natural look and feel. The adjustable implants give them the opportunity to “try on” different implant sizes – in their own body, during their recovery period.
Follow up photos are shown 2 years after her mastectomies and 3 months after implant exchange and medical tattoo.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
