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Before and after bilateral breast revision in a 42 year old breast cancer survivor. She had previously undergone neoadjuvant chemotherapy to shrink her left breast cancer, bilateral skin sparing mastectomies and tissue expander reconstruction. She also had radiation therapy to her left chest wall, as evidenced by the darker color of her left breast and chest skin and slightly contracted breast envelope.  

Her reconstruction revision involved removal of her tissue expanders, replacement of her pectoralis major muscles to the chest wall, and insertion of smooth round silicone gel breast implants in the prepectoral position, on top of the muscle.  

“Dog ears”, or standing cone deformities, were excised from the sides of her breast reconstructions from her past surgery. These standing corners are often left after surgery where the tissue is not contoured to its new form, like in a breast reduction or abdominoplasty.  

Nipple and areola reconstructions were created using the local flap technique for the nipples and medical tattoo for the areolas. The left radiated nipple reconstruction is healing slowly, as is common for radiated tissue.  

Follow up photos are shown 6 weeks after surgery. She has much better symmetry and a more aesthetically pleasing breast reconstruction result. Her animation deformity is gone and she feels ready to finally go back to work. 

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

Dr Karen Horton