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Before and after breast reconstruction revision in a 56-year-old woman who was also a breast cancer survivor. She previously had undergone a skin-sparing but non-nipple-sparing mastectomy and tissue expander reconstruction. Her left implant was under the muscle, causing it to sit too high on her chest and she experienced an animation deformity each time she flexed her chest muscles.

Her revision involved removal of the old implant, returning her left pectoralis major muscle to the chest wall, and insertion of a new smooth round silicone gel breast implant on top of the muscle, in the prepectoral position.

Nipple and areola reconstruction was performed on the left using the right-to-left “nipple sharing” (free nipple graft) technique and medical tattoo. The right nipple became fifty percent smaller and maintained its normal sensation. The nipple graft healed very well on the left breast and looked like it had always been there!

Her right breast was also lifted at the same procedure to allow her nipples and areolas to sit at the same height. Liposuction removed excess fat from her armpits and bra rolls (the axillary rolls). Follow up photos are shown 3 months after surgery.

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

Dr Karen Horton