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Before and after bilateral breast reconstruction revisions in a 62 year old breast cancer survivor. Her previous implants were under the muscle, with a significant animation deformity. She felt they were too big for her frame.  

The textured surface of the implant prevented them from moving at all, and they felt stiff and stuck on her chest. She also had excess fat in her upper armpit region that was not removed at the time of her mastectomies that was contributing to her poor aesthetic outcome.

Her breast revision involved removal of her larger implants, separation of her pectoralis major muscles from the undersurface of her breast skin, and reconstruction of her normal chest muscle anatomy. A new prepectoral implant space was created.  

New smooth round silicone gel breast implants were placed on top of the muscle, and liposuction of her axillary rolls permanently removed fat from her upper outer pole of the breasts. Free fat graft was harvested from her belly and inner knees, but due to the extremely thin nature of her mastectomy skin flaps, very little fat was accepted into her chest wall skin.  

Early follow up photos are shown one month after surgery.  Whereas her former implants were stiff and immobile, her new smaller implants are soft and mobile. She has begun implant massage and is nearly ready for scar therapy.  

She appreciates her smaller, perky breasts that she feels suits her frame better. She loves her armpits despite their residual swelling and is wearing tank tops, now without giving it a second thought.

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

Dr Karen Horton