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Before and after right implant reconstruction and left balancing augmentation in a 45 year old woman. She was previously treated for breast cancer with a right lumpectomy, radiation therapy and chemotherapy. She wished to be reconstructed slightly fuller than her post-partum deflated breast size.

Smooth round silicone gel implants were placed on top of the muscle, in the “prepectoral position”. This has been the standard of practice since I began my practice in 2006. Implants are always placed on top of the muscle, regardless of whether the surgery is cosmetic or reconstructive and whether the breast has been radiated or not.

Avoidance of the muscle makes recovery very easy, with most patients taking pain medication for the first day after surgery and plain Tylenol after that. The breasts do not distort with muscle flexion, known as the “animation deformity” or “flexion/motion deformity”.

A lift of the nipples and areolas was performed at the same time for symmetry. Follow up photos are shown a year after surgery. Her scars are still pink and will continue to fade over another year.

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

Dr Karen Horton