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Before and after bilateral breast reconstruction revision in a 41-year-old breast cancer survivor who lived out of state. Unfortunately, she was not offered nipple-sparing mastectomy nor prepectoral implant reconstruction when she was diagnosed with breast cancer.

Her partially submuscular implants sat wide on her chest and limited her shoulders’ range of motion. She could not find a surgeon close to home who felt comfortable converting her implants to lie on top of the muscle.

She consulted with us via video and traveled to San Francisco for her surgery, staying a total of three weeks. Her revision surgery involved reopening her mastectomy incisions, separating her pectoralis major muscles from the undersurface of her breast skin, and returning her muscles to the chest wall. The pectoralis major muscles were reattached to the sternum and ribs with slowly absorbable sutures.

A new space for the implant was created on top of the muscle, in the space that the breast used to occupy. Smooth round silicone gel breast implants were placed in the subcutaneous space, giving her more natural cleavage and increased fullness, both of which were her reconstruction revision goals.

Early follow-up photos are shown two weeks after surgery. She is ready to travel home soon; future follow-ups will be on video with her next in-person follow-up visit in one year.

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

Dr Karen Horton