Patient 11 Gallery

Before and after breast reconstruction revision in a 63 year old breast cancer survivor. Her past reconstruction had removed her nipples and placed implants under the muscle, creating an obvious animation deformity. She hated the way that her breasts flexed and flattened when she reached her arms or pulled a door open. Her implants were mildly “bottomed out” due to the chest muscle pushing them downward – her implants fell below the natural breast fold and put pressure on her ribs.

She also was left with annoying fat collections in her armpits (which is normal fat that connects with the breast but is accentuated after mastectomy and especially when implants are placed in the submuscular position). This is one of the first details we look at when evaluating results of past breast surgery, both reconstructive and cosmetic. Liposuction of the “axillary rolls” (armpit fat and bra roll) is incorporated into each and every breast procedure in our practice.

Her revision involved removal of her older implants, replacing her pectoralis major muscles to the chest wall, and creation of a new pocket on top of the muscle, in the “prepectoral” position. New smooth round silicone gel breast implants were placed, and her inframammary folds were reconstructed. Liposuction thinned out her relatively thick layer of bra roll fat (seen on the images facing sideways) and removed unwanted fat from her armpits.

Follow up photos are shown 10 months after surgery. She previously thought that the “dog ear” resulting from a vertical incision made on her left breast would be an ideal location for a nipple. While it might be convenient to use this standing cone, the last image shows our plan for future nipple and areola reconstruction.

We have drawn an aesthetically pleasing location for planned nipple and areola reconstruction in the meridian (midline) of the right breast. This position is higher and looks more youthful than the standing cone scar on the left. She agrees that this looks very nice. We are planning an exciting new technique of nipple and areola reconstruction later this year!