Patient 23 Gallery

Before and after bilateral breast revision in a 57 year old breast cancer survivor.  She previously had undergone bilateral nipple sparing mastectomies for breast cancer.  She did not require chemotherapy or radiation therapy.

Her implants were partially under her pectoralis major muscles, creating a severe animation deformity whenever she flexed her muscles.  She wanted to stay around the same size but to have a more natural result, with less rippling. She felt like her implants were sliding down on her chest wall, putting pressure on her ribs.  

Her breast revision involved removal of her previously placed implants and separation of the pectoralis muscles from the undersurface of her mastectomy skin flaps.  Her muscles were returned to the chest wall and sutured firmly in place. A new prepectoral space was created for reconstruction. Her inframammary folds were reconstructed by long acting sutures, enabling the new implants to sit higher up on her chest.  

More cohesive (8th generation silicone gel) breast implants were placed on top of the muscle.  Fat grafting completed the procedure, harvesting fat from her central belly region and injecting it into her upper pole to help to thicken this area.  Most of the fat graft gets reabsorbed after free fat grafting – but “lipofilling” is a great way to improve the contour of the “donor site”! Learn more about free fat grafting here.  

Follow up photos are shown one month after surgery.  She has been given permission to start exercising and using her chest muscles again.  Her animation deformity has been completely eliminated and there is no longer ripples visible through her breast skin.  Her rib discomfort has also been relieved.

Her nipples are still sitting somewhat low due to swelling in the fold of her breast.  Over the next several months the bottom of her breasts will “round out” and the nipples will reflexly rotate forward to look less “ptotic” (low on the breast mound).  She is very happy with her “final reconstruction surgery” – as long as she continues to have a soft and symmetric result over the next several decades, there is no need for any further surgery!