Success Stories - Patient 697

Patient Info
Age:
53
Gender:
Female
Ethnicity :
White
Height:
5.0-5.5
Weight:
14
Reconstructive Procedure
  • Nipple Sparing Mastectomy
  • Tissue Expander Implant

Patient is a 53 year old business owner of a marketing firm. She loves animals and dancing. She was found to have DCIS on her screening mammogram and opted to have a nipple-sparing mastectomy for treatment. She had always desired larger breasts and planned for a contralateral augmentation at the final surgery to achieve her goals.

Surgery 2

Her initial surgery was to place a tissue expander and the same time as her nipple sparing mastectomy. She underwent weekly expansions, while continuing to work, and was happy at the 500cc mark. Her second surgery was to remove her tissue expander and exchange it for a permanent memory-shape implant on the right and at the same time she had a smaller moderate plus implant placed on the left for symmetry. At the same time, she was able to undergo a necessary gynecologic procedure for convenience.

Patient Info
Age:
62
Gender:
Female
Ethnicity :
Black
Height:
5.0-5.5
Weight:
163
Reconstructive Procedure
  • DIEP Flap Surgery

Patient is a 62 year-old mother of three. She is a nurse in the Clear Lake area and was found to have a mass on a screening mammogram in her right breasts. She opted to undergo bilateral mastectomy with immediate DIEP flap reconstructions.

Surgery 1

Bilateral mastectomy with immediate DIEP flaps. She had skin-sparing mastectomies and her DIEP flaps retained skin paddles initially for monitoring.

Surgery 2/3

Second stage surgery included revision of her reconstructions with excision of skin on her breasts for shaping and fat grafting along with revision of her abdomen. The second-stage surgery was to focused on lifting her breasts and making them younger and perkier. Aggressive liposuction was performed on her abdomen to add lipofilling to her upper medial breast reconstructions. Her third surgery was to reconstruct her nipples and this simple procedure was performed in the office with no downtime.

Surgery 4

Final step was areolar tattoo to complete her reconstruction. This too was done under local anesthetic in the office with little to no downtime.

Patient Info
Age:
54
Gender:
Female
Ethnicity :
Hispanic
Height:
5.0-5.5
Weight:
145
Reconstructive Procedure
  • Mastopexy
  • Breast Reduction
  • Lumpectomy Breast Reduction-Lift

Patient is a 54 year old nurse who had right breast cancer with a lumpectomy and radiation therapy many years ago. She developed asymmetry and a contour deformity after radiation that always bothered her. She was unable to find bras that fit both breasts well and was self-conscious in t-shirts and bathing suits.

Surgery 1

Reconstructive surgery included release of scar tissue and fat grafting to the right breast deformity laterally and left sided vertical reduction/mastopexy for symmetry. Fat was harvested from her abdomen, giving her a bonus of a trimmer tummy.

Patient Info
Age:
46
Gender:
Female
Ethnicity :
White
Height:
5.0-5.5
Weight:
175
Reconstructive Procedure
  • Breast Reduction
  • Lumpectomy Breast Reduction-Lift

Patient is a 46 you female day surgery nurse with a history of right breast cancer and underwent a lumpectomy and radiation. She also had spent her entire adult life wanting a breast reduction because of very large breasts and lots of back and shoulder pain. She developed breast asymmetry after lumpectomy and desired improvement in symmetry and her neck, back, and shoulder pain. She underwent right oncoplastic rearrangement and contralateral breast reduction.

Surgery 1

Right oncoplastic surgery (basically doing a breast reduction to fill in the defect from her lumpectomy) and left breast reduction. She now feels so much lighter, her clothes fit better and she can now wear a regular bra from any department store.........her dream.

Patient Info
Age:
38
Gender:
Female
Ethnicity :
Asian
Height:
5.6-6.0
Weight:
140
Reconstructive Procedure
  • Nipple Sparing Mastectomy

Patient is a 39 year old female diagnosed with left breast cancer and tested positive for the BRCA mutation. She actually felt the mass herself and then sought medical help. She opted to undergo bilateral nipple-sparing mastectomies with immediate tissue expander placement. Her goal was to have breasts very similar to her preoperative size and hoped to camouflage the differences in her chest cavity. She had always noticed a concave appearance to her right chest and ribs.

Surgery 2

The first surgery involved mastectomies and placement of tissue expanders. She has some slow healing on her left side at the location of the nipple. In addition, her expansion process was rather slow as she was undergoing chemotherapy to treat her cancer as well. Once she was happy with the size and all her chemo completed, she had removal of both tissue expanders and exchange for permanent memory-shape implants (Mentor MH/HP 345cc)

Patient Info
Age:
49
Gender:
Female
Ethnicity :
Asian
Height:
5.0-5.5
Weight:
125
Reconstructive Procedure
  • Breast Augmentation
  • Tissue Expander Implant

49 yo patient, mother of two boys, was diagnosed with left breast cancer, Stage 1. This was found on her screening mammogram. She opted to undergo mastectomy with immediate tissue expander placement and required adjuvant chemotherapy. She had always wanted larger breasts so the plan was for and expander and eventually a contralateral augmentation.

Surgery 1

Left tissue expander in place after completion of fill. She desired a larger right breast at her second surgery as well.

Surgery 2

Surgery 2 involved removal of her left tissue expander and placement of a permanent implant (Mentor memory shape MH/HP 495cc) and a contralateral right augmentation for symmetry (250cc MP Mentor smooth round implant). This gave her a larger breast size and cleavage she had always desired.

Patient Info
Age:
38
Gender:
Female
Ethnicity :
Hispanic
Height:
5.6-6.0
Weight:
115
Reconstructive Procedure
  • Tissue Expander Implant

38 year old female, mother of two young girls was found to have DCIS in both breasts. She never palpated a mass but opted to undergo a mammogram prior to 40 for baseline. She opted to have bilateral nipple-sparing mastectomies with immediate tissue expander placement using an inframammary fold incision. Her final surgery was to remove her tissue expanders and place her permanent implants.

Surgery 2

After expansion to a size she was happy with, she underwent removal of tissue expanders and exchange for permanent implants (555 Mentor MH/HP memory shape) with fat grafting to the superior/medial pole of the breast. She was very thin and knew there would be some rippling of her implants in time. Aggressive liposuction was performed from her only donor site, her flanks, to gain fat for grafting. Her final photos are 3 months after her last surgery and just over six months after her mastectomies.

Patient Info
Age:
46
Gender:
Female
Ethnicity :
White
Height:
5.0-5.5
Weight:
155
Reconstructive Procedure
  • Nipple Sparing Mastectomy
  • Tissue Expander Implant

Patient is a 46 year old engineer and was diagnosed with right breast cancer on her screening mammogram, Stage 0, and she desired larger breasts. She opted for a right nipple-sparing mastectomy, as her tumor was small and far away from her nipple, with immediate tissue expander placement.

Surgery 1

Right nipple-sparing mastectomy with immediate tissue expander placed. She underwent expansion to 500cc and was ready for exchange as well as symmetry augmentation.

Surgery 2

Removal of her right tissue expander and exchange for a permanent implant (Mentor MH/HP memory shape 555ccc) and left augmentation for symmetry (200cc smooth round Mentor MP). She also underwent fat grafting to the right breast to soften the superior pole and prevent the appearance of rippling later. Photos were taken 6 months after her mastectomy and three months after her last surgery.

Patient Info
Age:
67
Gender:
Female
Ethnicity :
White
Height:
5.0-5.5
Weight:
Reconstructive Procedure
  • Nipple Sparing Mastectomy
  • Tissue Expander Implant

67 year old grandmother of four presented with newly diagnosed right breast cancer on screening mammography. Suspicious calcifications in the right breast were biopsied returning back DCIS. Patient had a history of above the muscle silicone breast augmentation performed 30 years ago that were heavily encapsulated. She desired to have both breasts removed and a nipple sparing mastectomy through a vertical incision from the nipple down to the fold was offered to the patient.

Surgery 1

The first surgery included bilateral mastectomy through a vertical incision from the nipple down to the fold. Tissue expanders were then placed and after the patient healed up for two weeks, they were inflated in the office over the course of 2 months. Patient is seen below at full expansion with symmetrical breast mounds, ready for the next stage.

Surgery 2

The second surgery involves removal of both tissue expanders, placement of Alloderm to the lower pole to reinforce breast reconstruction, placement of permanent anatomic (gummy bear) implants, and fat grafting to correct small contour irregularities. Patient is seen below 6 months following the completion of her reconstruction.

Patient Info
Age:
43
Gender:
Female
Ethnicity :
Hispanic
Height:
5'8
Weight:
Reconstructive Procedure
  • Tissue Expander Implant

43 year old hispanic female presented with left breast cancer. She felt a lump in the upper outer quadrant of her left breast and workup then returned back invasive ductal carcinoma. Patient underwent chemotherapy first (neoadjuvant) in order to shrink the tumor and then elected for both breasts to be removed. She also desired to be of smaller size and was deemed a good candidate for direct to implant reconstruction with Alloderm sling.

Surgery 1

Patient underwent bilateral mastectomy with direct to implant immediate breast reconstruction. A permanent anatomic (gummy bear) implant was placed with a lower pole Alloderm sling for a single stage immediate reconstruction. She is seen below with well healed incisions and a symmetrical breast mound on both sides 4 months out.

3D Tattoo

The 3D tattoo is done in the office and does not require any anesthesia. Nipple and areola pigmentation brings the entire breast reconstruction to life. This patient is seen 6 months out after the completion of her 3D tattoo with a stable reconstruction, symmetrical breast mounds and an acceptable result.

Patient Info
Age:
48
Gender:
Female
Ethnicity :
White
Height:
5'3
Weight:
130
Reconstructive Procedure
  • DIEP Flap Surgery

48 year old insulin dependent diabetic presented with newly diagnosed left breast cancer. A screening mammography demonstrated suspicious calcifications of the left breast. Subsequent stereotactic biopsy returned back DCIS. Patient expressed a strong desire for both breasts to be removed and was deemed a good candidate for immediate DIEP flap reconstruction.

Stage 1

Incisions were confined to the areola and the nipple areolar complex was removed with the breast specimen. The breasts were then immediately reconstructed with DIEP flaps. Patient is seen below three month after initial mastectomy surgery.

Stage 2

Nipples were reconstructed by way of modified CV flaps and fat grafting to both breasts was also performed in order to improve the upper pole of the breasts.

3D Tattoo

The 3D tattoo is done in the office and does not require any anesthesia. The finishing touches that brings a completed reconstruction to life include the pigmentation to restore the areolar color. This patient seen below is 6 months out after the completion of her 3D tattoo with a stable reconstruction, symmetrical breast mounds and an acceptable result.

2 years out from tattoo

Patient is seen below with a stable reconstruction 2 years out from completing her tattoo.

Patient Info
Age:
43
Gender:
Female
Ethnicity :
White
Height:
5'6
Weight:
148
Reconstructive Procedure
  • Nipple Sparing Mastectomy
  • Tissue Expander Implant

43 year old caucasian female presented with newly diagnosed left breast cancer. Patient self palpated a breast lump at the 11 o\'clock position of the left breast. Subsequent workup returned back infiltrating ductal carcinoma. Patient elected for bilateral mastectomy with the right breast being removed for preventative measures.

Surgery 1

Patient had a bilateral mastectomy through a well concealed inframammary fold incision. Tissue expanders were placed in the breast pocket after the mastectomy. Tissue expanders were inflated on a weekly basis to the size that the patient desired. She expressed a strong interest in being a larger size and when acceptable for the patient, she underwent removal of both tissue expanders, placement of Alloderm to the lower pole for reinforcement and insertion of permanent anatomic (gummy bear) silicone implants. Patient is seen below with a stable reconstruction 6 months out.

Patient Info
Age:
42
Gender:
Female
Ethnicity :
White
Height:
5'6
Weight:
125
Reconstructive Procedure
  • DIEP Flap Surgery

42 year old caucasian mother of two presented with newly diagnosed right breast cancer. Patient palpated a lump in the right breast and then sought the attention of her OB/GYN. Workup which consisted of a biopsy of the right breast mass returned back infiltrating ductal carcinoma. Patient elected to have a right sided mastectomy with immediate DIEP flap reconstruction of the right breast. A negative intraoperative lymph node came back positive after the final pathology resulting in the need for additional radiation therapy to the right reconstructed breast.

Surgery 1

Patient is seen below after successful right mastectomy with immediate DIEP flap reconstruction and radiation to her right breast.

Stage 2

After healing up for 6 months after radiation therapy, the patient underwent nipple reconstruction with modified CV flaps.

3D tattoo

The 3D tattoo is done in the office and does not require any anesthesia. Areola and nipple pigmentation by 3D tattoo are the finishing touches that bring the breast reconstruction to life. This patient is seen 6 months out after the completion of her 3D tattoo with a stable reconstruction, symmetrical breast mounds and an acceptable result.

Patient Info
Age:
40
Gender:
Female
Ethnicity :
White
Height:
5'6
Weight:
145
Reconstructive Procedure
  • Breast Augmentation
  • DIEP Flap Surgery

40 year old caucasian female presented with newly diagnosed right breast cancer. Patient had her first mammogram performed demonstrating a suspicious mass at the 6 o\'clock position of the right breast. She had two previous pregnancies and was an excellent candidate for DIEP flap reconstruction of both breasts given her excess skin and fat in the lower abdominal area. She elected to have both breasts removed and also desired to be of larger breast size if possible.

Surgery 1

The bilateral mastectomy and immediate DIEP flap reconstruction was performed at the first surgery to create breast mounds. Her nipple and areola were not spared and that skin was replaced with skin from her abdomen. Symmetrical stable breasts mounds are seen in this patient after the first stage and she is seen three months out while undergoing chemotherapy.

Surgery 2

The patient expressed a strong desire to be of larger bra size and at the first revisional surgery, implants were placed behind the DIEP flap and muscle to increase volume, projection and improve shape. Additional liposuction was also performed in the abdomen and waist to improve body contour. The fat that was suctioned was saved, purified and then grafted (injected) to the breast and upper poles to additionally gain more volume and smooth out contour irregularities. The nipple was also reconstructed at this stage as well.

3D Tattoo

The 3D tattoo is done in the office and does not require any anesthesia. The finishing touches that brings a completed reconstruction to life include the pigmentation to restore the areolar color. This patient is seen 6 months out after the completion of her 3D tattoo with a stable reconstruction, symmetrical breast mounds and an acceptable result.

Patient Info
Age:
48
Gender:
Female
Ethnicity :
Asian
Height:
5.5
Weight:
135
Reconstructive Procedure
  • Nipple Sparing Mastectomy
  • Tissue Expander Implant

48 year old Asian female presented with newly diagnosed left breast cancer. The patient had a breast augmentation in the past with implants under the muscle. She desired to be of similar size and did not have enough tissue in the abdomen for DIEP flap reconstruction. However, she was a good candidate for nipple sparing mastectomy and implant based reconstruction.

Surgery 1

A nipple sparing mastectomy through an inframammary fold incision was performed in order to the conceal the scar. Tissue expanders were placed in the space where the implants were removed from right after the mastectomy. The tissue expanders were then slowly expanded in the office after two weeks of recovery. After achieving the size that the patient desired, the first revisional surgery was performed. Patient is shown below right before removal of tissue expanders and placement of permanent implants.

Surgery 2

The tissue expanders were removed through the same inframammary fold incision below the breast. The expanders were removed and then Alloderm placed in the lower pole in order to reinforce the reconstruction. Anatomic (gummy bear) shaped implants were placed to optimize shape, volume and projection. Additional liposuction of the abdomen and waist was performed with fat being purified and grafted to the upper chest. She is seen below 3 months after the completion of her reconstruction.

Patient Info
Age:
41
Gender:
Female
Ethnicity :
White
Height:
5'3
Weight:
140
Reconstructive Procedure
  • DIEP Flap Surgery

41 year old mother presented with suspicious calcifications in the left breast on her yearly screening mammogram. Patient desired to have immediate reconstruction with DIEP flap reconstruction in a single nipple sparing mastectomy surgery and deemed an excellent candidate by her breast surgeon and surgeon at Memorial Plastic Surgery. Nipple sparing mastectomy was performed through an incision that started at her nipple and ended at the fold of her breast.

Surgery 1

Patient had a successful reconstruction of the right breast with DIEP flap however sustained a clot in the left breast on the fourth day in the hospital where the flap was lost. The flap was removed and then a tissue expander placed on the left side to reconstruct that breast. She is seen 3 months out just before her first revisional surgery.

Surgery 2

The first revisional surgery included removal of left breast tissue expander, placement of permanent implant with Alloderm to the lower pole and aggressive fat grafting to both breasts. The fat was liposuctioned from the abdomen and waist in order to improve body contour. Although the left DIEP flap was lost, a symmetrical reconstruction was still achieved with an implant on the left.

Patient Info
Age:
43
Gender:
Female
Ethnicity :
Black
Height:
5'7
Weight:
Reconstructive Procedure
  • DIEP Flap Surgery

43 year old African American female presented with newly diagnosed left breast cancer. Patient had screening mammogram performed demonstrating suspicious calcifications in the left breast. Workup returned back DCIS and patient elected to have both breasts removed. She desired to use her own tissue for reconstruction and the patient was deemed an excellent candidate for DIEP flap reconstruction.

Surgery 1

The mastectomy and DIEP flap reconstruction was performed in a single stage to create a stable breast mound. After three months, the patient underwent her first revisional surgery which included additional implant augmentation under the DIEP flap, fat grafting to both breasts to improve contour, and nipple reconstruction with labial grafts. She is seen below after her first revisional surgery with acceptable symmetrical breast mounds with good shape and projection.

3D Tattoo

The 3D tattoo is done in the office and does not require any anesthesia. The finishing touches that brings a completed reconstruction to life include the pigmentation to restore the areolar color. This patient is seen 1 year out after the completion of her 3D tattoo with a stable reconstruction, symmetrical breast mounds and an acceptable result.

Patient Info
Age:
49
Gender:
Female
Ethnicity :
Asian
Height:
5'2
Weight:
140
Reconstructive Procedure
  • Nipple Sparing Mastectomy
  • DIEP Flap Surgery

49 year old Asian female presented to Memorial Plastic Surgery with newly diagnosed right breast cancer. Patient had noticed a mass over the course of two years that was slow growing and not painful. After being more concerned about the increasing size, she sought the attention of her OB/GYN who ordered a biopsy returning back infiltrating mucinous carcinoma. Patient chose to have both breasts removed and did not want reconstruction with implants and had a strong desire to use her own tissue. She was an excellent candidate for nipple sparing mastectomy through an inframammary fold incision and immediate DIEP flap reconstruction of both breasts.

Surgery 1

This patient was completely in a single stage of reconstruction. Patient was able to achieve symmetrical breast mounds in a single stage and because of her nipple sparing mastectomy, did not require any further reconstruction. She had minimal contour irregularities, did not desire to seek any further revisions and returned back to her normal life in 3 months.

Patient Info
Age:
52
Gender:
Female
Ethnicity :
Black
Height:
5'5
Weight:
160
Reconstructive Procedure
  • DIEP Flap Surgery

52 year old African American female presented with aggressive right breast cancer that involved the skin. Patient was seen by Memorial Plastic Surgery and due to the large amount of skin to be resected, recommended a DIEP flap reconstruction. Skin from the abdomen was planned to patch the skin defect of the right breast after the mastectomy.

1 year after completion of reconstruction

After initial mastectomy and immediate DIEP flap reconstruction of the right breast, patient underwent additional revisional surgery to include aggressive liposuction and fat grafting to the right breast along with nipple reconstruction with modified CV flaps and 3D tattoo. She is seen below with a stable reconstruction 1 year out after completing her reconstruction.

Patient Info
Age:
39
Gender:
Female
Ethnicity :
Hispanic
Height:
5'7
Weight:
135
Reconstructive Procedure
  • Nipple Sparing Mastectomy
  • Tissue Expander Implant

39 year old hispanic female presented with a palpable breast mass. Breast mass was slowly growing and she presented to her OB/GYN for further evaluation. Imaging and biopsy returned back infiltrating ductal carcinoma. A coordinated approach with her breast surgeon offered the patient a nipple sparing mastectomy through an incision along the fold for optimal results. Incision would be well hidden underneath the breast and tissue expanders were placed in her first surgery at the time of the mastectomy.

1 year postop

After tissue expanders were inflated to the size the patient desired, she underwent removal of tissue expanders, placement of Alloderm to the lower pole for reinforcement, and placement of anatomic (gummy bear) implants. Additional fat grafting was also performed to the upper pole of both breasts to produce a smoother contour and transition from skin to implant. She is seen 1 year out with a stable reconstruction.

Patient Info
Age:
44
Gender:
Female
Ethnicity :
Black
Height:
5'7
Weight:
205
Reconstructive Procedure
  • DIEP Flap Surgery

44 year old ICU nurse and mother of two presented with left breast cancer. Patient had a screening mammography performed demonstrating suspicious calcifications in the right breast. Stereotactic biopsy returned back infiltrating ductal carcinoma. She elected to have a bilateral mastectomy and immediate DIEP flap reconstruction after visiting with her breast surgeon and surgeon at Memorial Plastic Surgery.

Surgery 1

Skin sparing mastectomy was performed along with immediate DIEP flap reconstruction. Patient is seen below six months out after the initial surgery. She had to undergo chemotherapy after mastectomy and progression of her reconstruction was delayed until she was done with chemotherapy. She has stable symmetrical breast mounds still proportional to her body.

Surgery 2

Revisional surgery was performed in the second surgery to fat graft both breasts and nipple reconstruction with modified CV flaps. 3D tattoo was performed in office to finish her reconstruction. She is seen below with a stable reconstruction one year out from her last revisional surgery.

Patient Info
Age:
56
Gender:
Female
Ethnicity :
White
Height:
5'8
Weight:
160
Reconstructive Procedure
  • Latissimus Muscle

56 year old caucasian female presented with newly diagnosed right breast cancer. Patient noticed an indention in the lower portion of her right breast along with an associated mass behind her nipple. After workup was complete, a diagnosis of infiltrating ductal carcinoma was found. She was seen at Memorial Plastic surgery where recommendations were made for reconstruction. Patient was not a nipple sparing candidate since the cancer was too close to the nipple and surrounding skin and additional skin was to be resected around the nipple areolar complex in order to ensure adequate resection of cancer.

Surgery 1

A skin sparing mastectomy was performed on the right breast removing not only the nipple areolar complex but also surrounding skin below. The defect was reconstructed in a single stage with a latissimus flap (back muscle) with an immediate implant. She is seen below 1 week out from surgery with a reconstructed breast mound of comparable size to the left breast. Drains are still in place and there is expected mild bruising.

Surgery 2

3 months after her initial mastectomy, patient underwent her first revisional surgery to include aggressive fat grafting to smooth out any contour irregularities. Successful fat grafting will enhance breast shape and optimize outcome by providing better symmetry. She is seen 3 months out after revisional surgery of the right breast.

Surgery 3

After optimizing breast shape and volume, the reconstruction is completed with nipple reconstruction and tattoo. The nipple was reconstructed with local tissue on the breast mound (modified CV flap). Patient is seen below three months out with a well healed symmetrical nipple.

3D Tattoo

Finishing touches to the breast reconstruction involves 3D tattoo. Completed and stable reconstruction is seen below 6 month out from tattoo. Tattoo of areola will frequently fade and require touch-ups. Patient declined any further intervention and was overall happy with reconstruction.

Latissimus Donor Site

The latissimus flap involves a scar from the back in order to harvest both skin and muscle. The progression of the scar is seen below at 3 months, 6 months and 1 year from initial mastectomy surgery.

Patient Info
Age:
50
Gender:
Female
Ethnicity :
White
Height:
5.6-6.0
Weight:
Reconstructive Procedure
  • Breast Reduction
  • Lumpectomy Breast Reduction-Lift

63 year old grandmother of 6 presented with newly diagnosed right breast cancer. Patient had a screening mammogram performed revealing a 1.6 cm mass at the 11 o\\\'clock position of the right breast. Patient elected to have breast conservation therapy and desired to be treated with a lumpectomy in conjunction with breast lift/reduction at the same time. This combined procedure helps reduce asymmetry and improve overall cosmetic result with repositioning of the nipple onto the center of the breast mound. Below are her preoperative photos.

4 weeks after lumpectomy and reduction/lift procedure

Patient is seen below 4 weeks after lumpectomy surgery. Patient already prepped (simulated) for radiation therapy to start.

6 months out from completion of radiation therapy

Patient was allowed to heal for 4 weeks and then underwent radiation to the right breast for 6 weeks. Radiation therapy is necessary in patients who have a lumpectomy in order to reduce recurrence rate. Radiated right breast is seen symmetrical with left side and below photos are 6 months out from completion of radiation therapy to the right breast.

2 years out from completion of radiation therapy

Reconstruction remains stable at 2 years.

Patient Info
Age:
53
Gender:
Female
Ethnicity :
Hispanic
Height:
5.0-5.5
Weight:
210
Reconstructive Procedure
  • DIEP Flap Surgery

53 year old Hispanic female presented to Memorial Plastic Surgery for delayed right breast reconstruction. Patient was diagnosed with invasive right breast cancer with spread to her lymph nodes. Patient was treated outside of Houston with a right mastectomy and removal of all of her axillary lymph nodes. She also underwent chemotherapy and radiation to her right breast to reduce recurrence and to increase survival. Patient was disease free for 3 years before seeking delayed breast reconstruction of the right breast. She also desired to have a prophylactic left mastectomy to prevent future risk of cancer to the left breast.

Surgery 1

Below: Patient is seen six months after successful reconstruction of both breasts. The left breast was removed and then both breasts reconstructed with DIEP flaps. One surgery achieved two new breast mounds.

Surgery 2

Revisional surgery are typically day surgery with a weekend worth of recovery. Patient underwent 2 hours of surgery and was discharged home the same day. In this revisional surgery, patient underwent more aggressive liposuction of the abdomen with fat grafting to both reconstructed breast to gain better symmetry. Nipples were also reconstructed at that time with modified CV flaps from local tissue on the breast. Below, she is seen 3 months out with a full recovery.

3D Tattoo

Finishing touches to complete the reconstruction include in office 3D tattoo. Pt underwent 3D tattoo with our professional tattoo artist.

Patient Info
Age:
30
Gender:
Female
Ethnicity :
Hispanic
Height:
5.0-5.5
Weight:
140
Reconstructive Procedure
  • DIEP Flap Surgery

46 year old mother of two and busy flight attendant presented with a chronically enlarging left breast over the course of 1 year. Because of her busy schedule, patient continued to work despite having multiple mammograms and biopsies that all returned back benign or unequivocal. Mass continued to grow and patient was eventually seen by a breast surgeon. Further incisional biopsy all returned back with an inconclusive diagnosis. Patient was then seen by Memorial Plastic Surgery where the decision was made cohesively to perform a left mastectomy with immediate DIEP flap reconstruction. A breast reduction would potential leave diseased tissue behind and also result in poorer symmetry. Patient agreed to DIEP flap reconstruction and was an excellent candidate give her multiple pregnancies and moderate amount of excess skin and fat in her lower abdomen.

Surgery 1

Patient is shown below three months after initial left simple mastectomy with immediate DIEP flap reconstruction. The flap is intentionally made larger in order to have excess tissue to shape later. Patient also had a large amount of redundant skin. Patient shows a well healed DIEP flap ready for the next stage of revision that is typically three months after the mastectomy.

Surgery 2

Below shows the patient after revisional surgery which consisted of left nipple reconstruction, reduction of areola skin paddle and liposuction of DIEP flap to surgery shape to match the right breast.

Surgery 3

Further shaping as well as fat grafting was performed to continue to mold the left breast to match the right breast. Each stage typically contains some fat grafting to improve mild contour depressions and irregularities.

3D Tattoo

Final stage of reconstruction restore the entire breast with a 3D tattoo. 3D tattoo was performed in office with professional tattoo artist Kat who pigmented the left breast nipple to match the right breast. Each revision is usually separated by three months concluding in the in office 3D tattoo.

Patient Info
Age:
50
Gender:
Female
Ethnicity :
White
Height:
5.0-5.5
Weight:
Reconstructive Procedure
  • Nipple Sparing Mastectomy
  • Tissue Expander Implant

51 year old caucasian female presented with newly diagnosed right breast cancer. Patient self palpated a right breast lump on the upper inner quadrant of her left breast. Being a vivacious single 51 year old, patient was extremely concerned of cosmetic results and desired to pursue a nipple sparing mastectomy. Below are her preoperative photos.

After mastectomy and Tissue expander placement

Patient underwent a nipple sparing mastectomy through the inframmary fold incision. Her final pathology returned back with positive skin margins at the right inner breast. She underwent an additional procedure in order to resect additional skin that still harbored breast cancer. Below are her photos after full tissue expander inflation before exchange to permanent implants. Note the scar on the inner upper aspect of the right breast where additional skin was resected.

1 year after placement of permanent implants

Tissue expanders were removed and placement of permanent anatomic shaped implants in a second surgery. Alloderm was also placed into both breast pockets in order to reinforce the reconstruction. Additional fat grafting was performed to improve contour, smooth out irregularities and to prevent rippling. She is seen below 1 year after placement of permanent implants.

Patient Info
Age:
30
Gender:
Female
Ethnicity :
White
Height:
5.0-5.5
Weight:
Reconstructive Procedure
  • Nipple Sparing Mastectomy
  • Tissue Expander Implant

40 year old newly wed patient underwent her first mammogram with devastating findings. Patient was found to have a large area of suspicious calcifications seen in the upper outer quadrant of the left breast. Biopsy returned back with infiltrating ductal carcinoma. Patient also has a history of saline breast augmentation placed below the muscle. She elected to have both breasts removed with immediate reconstruction and desired a nipple sparing mastectomy with tissue expander/implant based reconstruction. Nipple sparing mastectomy was performed through an inframmary fold incision under the breast. Below are her preoperative photos.

Tissue Expander to Permanent Implants

After achieving a proper bra size that was proportional and acceptable for the patient, she underwent removal of tissue expanders with exchange to permanent silicone implants. Anatomic silicone implants were placed along with Alloderm internal sling to reinforce the reconstruction. Aggressive liposuction of the abdomen and flanks with fat grafting to the entire breast was also performed to improve contour, symmetry and prevent rippling. Below are her final results 3 months after her last surgery.

Patient Info
Age:
69
Gender:
Female
Ethnicity :
White
Height:
5.6-6.0
Weight:
Reconstructive Procedure
  • Nipple Sparing Mastectomy
  • Tissue Expander Implant

69 year old grandmother self palpated a left breast mass in the fall of 2014. Her mass was felt at the upper outer quadrant of her left breast and she visited with her OB/GYN who ordered a mammogram. Further biopsy returned back infiltrating ductal carcinoma. Pt desired to pursue a nipple sparing mastectomy and elected for bilateral mastectomy to reduce future screening and anxiety.

Surgery 1

Pt had nipple sparing mastectomy through an inframmary fold incision. Tissue expanders were placed above the muscle in the prepectoral space. This allowed for salvage of the pectoralis major muscle and to eliminate animation deformity. Tissues expanders were gradually filled to 400 cc and here you see the patient prior to exchange to permanent anatomic silicone implants.

Surgery 2

After achieving the proper bra size, patient then underwent exchange of her tissue expanders to permanent silicone implants. Anatomic shaped implants were used along with placement of Alloderm internal sling to reinforce the reconstruction. Aggressive fat grafting was performed to the upper poles of both reconstructed breast in order to smooth out contour irregularities and to achieve a smoother transition in the upper part of the breast. Fat grafting was also performed in the lower portions of the breast to help reduce rippling. A congenitally inverted left nipple was corrected at the same time. Below are her final reconstructive results three months out from her second surgery, 6 months out from her mastectomy.

Patient Info
Age:
55
Gender:
Female
Ethnicity :
White
Height:
5'5
Weight:
175 pounds
Reconstructive Procedure
  • Mastopexy
  • DIEP Flap Surgery

55 year old healthy mother of two presented to Memorial Plastic Surgery with newly diagnosed left breast cancer. While undergoing her yearly scheduled mammogram, she was found to have a 1.3 cm suspicious mass at the 11 o\\\'clock position of the left breast. An ultrasound guided core biopsy was performed and a diagnosis of infiltrating ductal carcinoma was confirmed. Patient desired to have a mastectomy and elected for both breasts to be removed with the right being preventative. She was not a good candidate for nipple sparing given her low positioned nipple but an excellent candidate for immediate DIEP flap reconstruction given her two previous pregnancies and excess skin and fat in the lower abdomen.

Mastectomy and Immediate DIEP flap reconstruction

Patient underwent a bilateral mastectomy in conjunction with immediate DIEP flap reconstruction of both breasts on the same day. A lift was also performed at the same time in order to raise her nipple position for optimal final result. Symmetrical breast mounds are created in the first stage of surgery and patient is seen below three months out after her mastectomy and DIEP flap reconstruction.

Surgery 2

Second surgery in breast reconstruction is revisional surgery. Revisional surgery is typically day surgery with a weekend worth of recovery. In this second stage, the patient had aggressive liposuction of the abdomen and waist to improve body contour. The fat suctioned was saved, purified and then grafted (injected) into the upper poles of both breasts in order to smooth out any contour irregularities and optimize upper pole fullness. She also had nipple reconstruction performed at the same time with free earlobe grafts. Patient is seen below three months after healing from her first revisional surgery.

3D tattoo

The 3D tattoo is done in the office and does not require any anesthesia. The finishing touches that brings a completed reconstruction to life include the pigmentation to restore the areolar color. This patient is seen 6 months out after the completion of her 3D tattoo with a stable reconstruction, symmetrical breast mounds and an acceptable result.

Patient Info
Age:
48
Gender:
Female
Ethnicity :
Hispanic
Height:
5'7
Weight:
190
Reconstructive Procedure
  • DIEP Flap Surgery

48 year old hispanic female presented with left breast cancer in the upper outer quadrant. Patient self palpated a mass while showering and her concerns brought her to her OB/GYN. After extensive workup with mammogram and ultrasound, the patient was diagnosed with infiltrating ductal carcinoma. After visiting with her breast surgeon, she was referred to Memorial Plastic surgery for immediate reconstruction after mastectomy. Patient elected to also have a right prophylactic mastectomy and although not a nipple sparing candidate, she was deemed a good areola sparing candidate. She was also an excellent candidate for DIEP flap reconstruction given her previous pregnancies and body habitus.

Surgery 1

Patient is seen three months out after her initial mastectomy below. Symmetrical and stable breast mounds are seen after the first surgery with immediate reconstruction. Patient desired to have revisional surgery to increase breast projection and volume of her reconstructed breast.

Surgery 2

Her first and only revisional surgery included aggressive liposuction of the abdomen and waist with fat grafting (injections) to the upper poles of both breasts. The nipples were reconstructed with modified CV flaps and implants were also placed under the DIEP flap and muscle to increase projection and volume. She is seen 1 year out from her final revisional surgery with good shape, symmetry and volume.

Patient Info
Age:
60
Gender:
Female
Ethnicity :
Hispanic
Height:
5'4
Weight:
185
Reconstructive Procedure
  • DIEP Flap Surgery

60 year old hispanic grandmother of 3 presented with left breast cancer. Patient underwent her yearly mammogram demonstrating suspicious calcifications in the left breast. She elected to have bilateral mastectomy with immediate DIEP flap reconstruction and was offered areola sparing mastectomies to optimize cosmetic outcome.

1 year out after completion of reconstruction

Patient underwent a successful immediate DIEP flap reconstruction of both breasts with symmetrical breast mounds. Her second surgery was performed three months after her initial mastectomy and included aggressive liposuction of the abdomen and waist line for better contour in addition to nipple reconstruction with free ear lobe grafts. The fat that was liposuctioned from her waist and abdomen was grafted (injected) to the breasts and upper pole. Injected fat produced more volume and projection which the patient desired. She is pictured below one year out after completion of her reconstruction.

Patient Info
Age:
48
Gender:
Female
Ethnicity :
Black
Height:
5.0-5.5
Weight:
155
Reconstructive Procedure
  • DIEP Flap Surgery

48 year old African American patient presented with left breast cancer. Her history began with a left breast mass that was initially treated with a lumpectomy by a breast surgeon. Unfortunately, the patient had positive margins on her final pathology and was then offered a mastectomy to completely resect the disease in her left breast. After not being a good lumpectomy candidate, the patient opted to also have a right mastectomy as well. After visiting with her surgeon at Memorial Plastic Surgery, she was not a nipple sparing candidate however an areola sparing mastectomy with immediate DIEP flap reconstruction was offered in order to optimize her cosmetic outcome.

Surgery 1 - DIEP flap

Areola sparing mastectomy was performed in the the first surgery with immediate DIEP flap reconstruction of both breast. She is seen here 4 months out after healing from her initial mastectomy with acceptable breast mounds but some mild contour irregularities in the upper poles of both breasts.

Surgery 2

Her first revisional surgery included aggressive liposuction to the flanks and abdomen with fat grafting to the upper chest to improve overall contour. The irregularities of the upper pole of the breast were smoothed out with fat that was suctioned from her abdomen.

Surgery 3

Patient decided to undergo a second round of liposuction and fat grafting to improve overall outcome. Additional liposuction of the abdomen and waist area improved her body contour and the fat was purified and grafted (injected) into both breasts to obtain more volume without using implants.

Nipple Reconstruction

Nipple reconstruction was performed with the same areola skin that was spared with modified CV flaps. Patient is seen below 6 months out after nipple reconstruction with stable and acceptable reconstruction.

Patient Info
Age:
45
Gender:
Female
Ethnicity :
White
Height:
5.0-5.5
Weight:
150
Reconstructive Procedure
  • DIEP Flap Surgery

45 year old healthy mother presented with suspicious calcification in the left breast on yearly mammogram. Subsequent workup with stereotactic biopsy returned back infiltrating ductal carcinoma. Patient desired to pursue a left skin sparing mastectomy and was not deemed an acceptable candidate for nipple sparing mastectomy given the proximity of the lesion to the nipple areolar complex. Because of her natural breast shape and one sided mastectomy, she was recommended a DIEP flap reconstruction of the left breast to obtain better symmetry. Implant based reconstruction would more likely result in two different breast shapes.

Surgery 1

Patient is seen below after successful left breast reconstruction with a DIEP flap three months out. The skin from the DIEP flap replaced the nipple and areola skin that was removed with the mastectomy. Left breast size is similar to the right breast however, right nipple is now lower than the left.

Surgery 2

The second surgery involves revisional surgery to obtain better symmetry between the right and left breast after a successful breast mound has been created. Aggressive liposuction of the flanks was performed to improve her body contour with the fat purified and grafted (injected) to the left breast. The majority of the fat graft is placed in the upper pole of the left breast to smooth out any contour irregularities and produce a smooth transition between the DIEP flap and mastectomy skin. The left nipple was also reconstructed with a modified CV flap and a breast lift symmetry operation was also performed on the right breast in order to raise the nipple to a better position.

3D Tattoo

The finishing touches to the reconstruction include the 3D tattoo. In office tattoo is performed three months after the nipple in reconstructed so that it is well healed. Patient is seen below 6 months after tattoo has been completed with a stable left breast reconstruction of comparable size to the right breast. DIEP flap donor scar from the abdomen is well hidden just below her underwear.

Patient Info
Age:
50
Gender:
Female
Ethnicity :
White
Height:
5.0-5.5
Weight:
120
Reconstructive Procedure
  • Nipple Sparing Mastectomy
  • Tissue Expander Implant

50 year old healthy mother presented with newly diagnosed left breast cancer. Patient had her yearly screening mammogram demonstrating a suspicious area in the upper outer quadrant of her left breast. Because the patient had a previous submuscular breast augmentation performed, she was not a good candidate for lumpectomy and radiation therapy. Radiation therapy with implants in place results in high capsular contracture rates in addition to a higher lifetime risk of implant infection on the radiated side. She was recommended nipple sparing mastectomy through an inframmary fold incision in order to optimize her cosmetic outcome and the patient decided on have a right prophylactic mastectomy as well.

Surgery 1

A nipple sparing mastectomy with an inframmary fold incision was performed on the patient and immediate tissue expanders were placed. Tissue expanders were placed in the same space as her breast implants in the sub muscular (below the muscle) space. After healing for 2 weeks, tissue expanders were filled to a size that was comparable to her preoperative bra size over the course of 6 weeks. In a second surgery, tissue expanders were then removed and the replaced with permanent silicone implants reinforced with Alloderm. She is seen below 1 year out after her initial mastectomy with a stable reconstruction and a well hidden scar along the inframammary fold.

Patient Info
Age:
47
Gender:
Female
Ethnicity :
White
Height:
5'8
Weight:
145
Reconstructive Procedure
  • Nipple Sparing Mastectomy
  • Tissue Expander Implant

47 year old healthy mother of two presented with abnormal findings on yearly screening mammogram. Study demonstrated a large area of calcifications in the right breast and patient underwent biopsy revealing infiltrating ductal carcinoma (IDC) in the suspicious area. Patient desired to have bilateral mastectomy to reduce her recurrence risk maximally due to being young and having two small children. Patient was seen at Memorial Plastic Surgery and a nipple sparing mastectomy through an inframammary fold incision was coordinated with a breast surgeon. Patient desired to be of slightly smaller size.

Surgery 1

After successful placement of the tissue expander in the first stage, patient is seen below after full expansion ready for exchange. Frequently, asymmetries exist after the initial mastectomy which can be corrected in the second revisional surgery. Plans for the second surgery included removal of tissue expanders, revision of both breast pockets, lowering of the left breast pocket, placement of Alloderm as an internal sling for reinforcement and placement of High profile anatomic (Gummy bear) implants for optimal shape and volume.

Surgery 2

Patient is seen below after removal of tissue expanders and placement of permanent anatomic (Gummy Bear) implants. Although breast symmetry is improved, patient and surgeon still had concerns regarding final result.

Surgery 3

Patient underwent a second revisional surgery that included aggressive liposuction of the abdomen and flanks with fat grafting to the entire breast to optimize shape and volume. Fat grafting is utilized to smooth out contour irregularities, thicken skin flaps and also improve shape and volume. Fat grafting is a common adjunct to any breast reconstruction to improve outcomes and also reduce fat deposits in specific areas that the patient complains about.

1 year postop

Patient is seen below at one after completion of reconstruction. Reconstruction has settled in and remains stable and acceptable. Scar is well hidden in the inframammary fold.

Patient Info
Age:
22
Gender:
Female
Ethnicity :
White
Height:
5.6-6.0
Weight:
110
Reconstructive Procedure
  • Breast Augmentation
  • Nipple Sparing Mastectomy
  • Tissue Expander Implant

22 year old female presented with her mother with a rapidly growing mass in the right breast. Patient first noticed the mass as a small gum ball and did not alert her mother until it continued to grow at a rapid rate. Upon presentation to her OB/GYN, the mass had grown to the size of a lemon within 3 months. Patient had biopsy performed with results highly suggestive of phyllodes tumor. Patient was immediately referred to a breast surgeon for excision. By the time the patient visited with her breast surgeon, the mass encompassed 40% of her breast. Excision of the mass alone would have resulted in an extremely poor cosmetic result and therefore recommendations of a mastectomy were discussed in order to ensure full resection of tumor and also to improve overall cosmetic outcome. Given the patients young age, a nipple sparing mastectomy through an inframammary fold incision was offered as to the best approach to conceal the scar. Patients first surgery included a nipple sparing mastectomy with immediate insertion of tissue expander.

Right breast reconstruction with left breast augmentation for symmetry

After the tissue expander was inflated to the desired size by the patient, she proceeded to the second surgery. Patient was encouraged to over expand past her preoperative bra size so that a small implant could be placed in the left breast to achieve better symmetry. Patient is seen below after the tissue expander was removed from the right breast with placement of permanent silicone implant with internal Alloderm sling for reinforcement. The left breast was augmented with a small implant to achieve increased volume and a better shape match when compared to the right breast. Patient is seen 3 months below after exchange and augmentation with good symmetry and a natural result.

Patient Info
Age:
52
Gender:
Female
Ethnicity :
Asian
Height:
5.0-5.5
Weight:
Reconstructive Procedure
  • Nipple Sparing Mastectomy

52 year old happily married Asian female presented to Memorial Plastic Surgery with right breast cancer. Patient first noticed a lump in her right breast which after workup revealed invasive ductal carcinoma. She underwent chemotherapy first in order to shrink the tumor (neoadjuvant chemotherapy). After reducing her tumor size, she was evaluated for immediate reconstruction after a right mastectomy. Patient was also deemed a good nipple sparing candidate based upon her tumor size and distance from the nipple. She was also deemed a good DIEP flap reconstruction candidate given her previous pregnancy and excess skin and fat in her lower abdomen.

Surgery 1

A nipple sparing mastectomy was then performed through an inframammary fold incision and an immediate reconstruction of her right breast with DIEP flap. Her incision on the right breast is well concealed and her reconstruction was successfully completed in a single stage. Patient also achieved the benefit of a tummy tuck resulting in a flatter abdominal profile.

Patient Info
Age:
51
Gender:
Female
Ethnicity :
White
Height:
5.0-5.5
Weight:
140
Reconstructive Procedure
  • Nipple Sparing Mastectomy
  • Tissue Expander Implant

51 year old mother presented with right breast cancer in 2014. Patient underwent a screening mammogram demonstrating suspicious calcification in the right breast. Further workup revealed DCIS. Patient elected for bilateral mastectomy and was a good candidate for nipple sparing mastectomy given her tumor size and far distance from the nipple.

Surgery 1

A nipple sparing mastectomy was performed through an inframammary fold incision for optimal cosmetic results. Below you see the patient three months after tissue expanders had been placed and inflated to 500 cc. Patient desired to be slightly larger than her preoperative bra size. Asymmetry is quite common after the initial mastectomy and subsequent revisions are made to improve outcome.

Surgery 2

At the second surgery after the mastectomy, the patient underwent removal of both tissue expanders with placement of permanent silicone implants. Alloderm is also routinely placed, such as in this patient, to reinforce the reconstruction and to prevent rippling. Additional fat grafting is routinely performed to smooth out contour irregularities, thicken mastectomy skin flaps and improve superior pole volume. Patient is seen 6 months after completion of second surgery with good symmetry, more projection, and a well concealed inframammary fold scar.

Patient Info
Age:
18
Gender:
Female
Ethnicity :
Hispanic
Height:
5.0-5.5
Weight:
Reconstructive Procedure
  • DIEP Flap Surgery

33-year-old mother presents with newly diagnosed left breast cancer. Biopsy returned back LCIS of the left breast and the patient elected for bilateral nipple sparing mastectomy with immediate DIEP flap reconstruction.

Surgery 1

Preoperative photos are shown above with the patient in 5 views. Nipple sparing mastectomy was performed through a vertical incision that skirted around the areola. She is seen below 2 months after her initial surgery with well-healed DIEP flaps in place.

Surgery 2

Patient\'s previous breast size was restored after the first initial surgery however, she desired to have more volume and better projection. She was offered to have implants placed behind both reconstructed breasts in order to achieve better shape and more volume. Patient is seen below after silicone implants have been placed under the DIEP flap. She is well-healed with better shape and projection and in overall good result. Patient is seen 6 months after placement of silicone implants.

Patient Info
Age:
58
Gender:
Female
Ethnicity :
White
Height:
5'3
Weight:
175
Reconstructive Procedure
  • DIEP Flap Surgery

58 yo mother of two daughters was diagnosed with left infiltrating ductal carcinoma. She is a housewife and helps her husband with their family-owned business. In the past, she had very large breasts and had a breast reduction. She also had lost a significant amount of weight after weightloss surgery, so she opted to reconstruct her breasts with her own tissue to get the benefit of a better looking tummy similar to the tummy tuck she had always desired. She underwent bilateral mastectomies with immediate DIEP flaps. She had two revision surgeries to improve her breast shape and her size was increased with implants under her DIEP flaps. She went on to get nipple reconstruction and 3D tattoos. She is so happy with her very natural,voluptuous reconstruction and her improved tummy tuck abdomen.

Surgery 1

Her first surgery was to remove both of her breasts and her nipples and areolas. At the same time, her abdominal tissue was transplanted to her chest to become her new breasts. This gave her the initial stages of her tummy tuck and reconstructed breasts.

Surgery 2

In this surgery, she had 350cc implants placed below her reconstructions in order to make her bigger and return her to her preoperative bra size. We also liposuctioned fat from her abdomen and thighs to graft to her upper breast reconstructions to improve their shape and contour. In this operation, we also performed her nipple reconstruction with C-V flaps.

Surgery 3

She underwent one additional revision to improve the fold under her left breast and to soften some areas of the upper inner aspect of her left reconstructed breast. Lastly, she underwent 3D areolar tattoo in our Memorial City office. This completed her reconstruction and gave her a beautiful result. She is elated with her body\\\\\\\'s image and her results. She has returned to all of her physical activies and is living life to it\\\\\\\'s fullest with her husband and grandchildren.

Patient Info
Age:
62
Gender:
Female
Ethnicity :
White
Height:
5.4
Weight:
165lbs
Reconstructive Procedure
  • Mastopexy
  • Breast Reduction
  • Lumpectomy Breast Reduction-Lift

This is a very pleasant 62 y.o. physician who was diagnosed with early stage left breast cancer. She did not want to have her breast removed and wanted to remain close to the same size as she is currently but wanted a more youthful fuller appearance. She decided to have breast conservation therapy with a lumpectomy for removal of the left breast cancer with oncoplastic rearrangement of the left breast to prevent a deformity and a mastopexy of the right breast for symmetry. She required radiation as part of her treatment plan for the left breast.

Surgery 1

This is a 6 week postoperative photo after lumpectomy of left breast cancer with oncoplastic rearrangement and mastopexy of right breast for symmetry. This is prior to radiation therapy.

Surgery 2

This is a 3 years s/p surgery and radiation therapy showing good symmetry. The patient is pleased with her results and continues to retain sensation.

Patient Info
Age:
42
Gender:
Female
Ethnicity :
White
Height:
5.6
Weight:
145lbs
Reconstructive Procedure
  • Mastopexy
  • Breast Reduction
  • Lumpectomy Breast Reduction-Lift

This is a pleasant 42 y.o. female who was diagnosed with left breast DCIS. She is a very active female who owns a plant nursery and wanted minimal surgery and recovery time. She decided to undergo breast conservation with a lumpectomy on the left with oncoplastic rearrangement to prevent a contour depression and a mastopexy of the right breast for symmetry.

Surgery 1

This is 2 weeks after a left lumpectomy for the left breast DCIS and oncoplastic reconstruction and mastopexy of the right breast for symmetry. Her incisions are healing without complication.

Surgery 2

This is one year after radiation therapy showing good symmetry and healed incisions.

Patient Info
Age:
39
Gender:
Female
Ethnicity :
White
Height:
5'6
Weight:
130lbs
Reconstructive Procedure
  • Breast Augmentation
  • Tissue Expander Implant

Patient is a 39 y.o. female diagnosed with early stage right breast cancer. Due to the location of the tumor she was not a candidate for nipple sparing mastectomy so had to have a skin sparing mastectomy. She was interested in implant reconstruction and an augmentation of the left breast. We decided on a two stage procedure to allow her to choose the size of breast she was interested in having.

Surgery 2

Photos after silicone implant placement on the right with fat grafting to upper chest deformity and an augmentation mammoplasty of the left breast for symmetry

Surgery 3

Photos showing nipple reconstruction.

Surgery 4

Photo showing micropigmentation of the nipple and areola. She is enjoying her larger breasts and is pleased with her results.

Patient Info
Age:
26
Gender:
Female
Ethnicity :
White
Height:
5.0-5.5
Weight:
135lbs
Reconstructive Procedure
  • Tissue Expander Implant

Patient is a 26 y.o. female diagnosed with BRCA 1 mutation who has an extensive family history of breast cancer who presented for implant based reconstruction after prophylactic nipple sparing mastectomies. She requested better symmetry of her breasts and larger breasts. She is a very active female who runs marathons and is training for the iron man.

Surgery 1

Photos demonstrating tissue expanders in place. The patient had some wound healing problems on the right breast from her mastectomy which was managed with local wound care. She was interested in silicone implants and fat grafting for her upper chest deformities.

Surgery 2

Photos demonstrating implants in place. She was pleased with her symmetry but decided she wanted larger implants and additional fat grafting.

Surgery 3

Photos demonstrating larger implants in place - she is so happy with her results and has done her first iron man race. She may return for fat grafting in the future to help with some of the rippling seen with her implants.

Patient Info
Age:
18
Gender:
Female
Ethnicity :
White
Height:
5.0-5.5
Weight:
Reconstructive Procedure
  • DIEP Flap Surgery

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Surgery 1

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Surgery 2

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Surgery 3

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Patient Info
Age:
51
Gender:
Female
Ethnicity :
White
Height:
5.6
Weight:
155lbs
Reconstructive Procedure
  • Tissue Expander Implant
  • Latissimus Muscle

The patient is a 51 y.o. female executive with a history of left sided breast cancer who underwent breast conservation and radiation therapy. Unfortunately, she was diagnosed with a new left sided breast cancer and was recommended to have bilateral mastectomies. Due to her prior radiation and need to remove her prior lumpectomy scar she necessitated the use of her own tissue with an implant to reconstruct the left breast and an implant only based reconstruction on the right. She received chemotherapy as part of her treatment plan. The patient has also suffered from lymphedema from her prior cancer surgery which is why she is wearing a sleeve on her left arm.

Surgery 1

Photos showing bilateral tissue expanders in place which are expanded to her desired volume and the latissimus dorsi myocutaneous flap on the left side.

Surgery 2

Photos showing results after placement of bilateral silicone implants and fat grafting to upper chest deformities.

Surgery 3

The patient did not want projecting nipples and therefore she underwent a 3-D tattoo which gives the illusion that a nipple exists. She has retired and is so pleased with her results.

Patient Info
Age:
30
Gender:
Female
Ethnicity :
Hispanic
Height:
5'5
Weight:
130
Reconstructive Procedure
  • Tissue Expander Implant

The patient is a 30 yo active female diagnosed with right breast cancer and BRCA2 mutation who underwent neoadjuvant chemotherapy and presented for bilateral skin sparing mastectomies. She was interested in implant based reconstruction and underwent a two stage procedure with initial tissue expander followed by placement of anatomic silicone implants. These are her preoperative photos.

Surgery 1

Photos demonstrating tissue expander fully inflated to her desired size.

Surgery 2

Photos after removal of tissue expanders and silicon anatomic implant placement with fat grafting to her upper chest deformities.

Surgery 3

Photos after nipple reconstruction with CV flaps

Surgery 4

Photos after areolar and nipple micropigmentation- final photos- she is extremely pleased and as her pictures demonstrate enjoying wearing a bathing suit.

Patient Info
Age:
29
Gender:
Female
Ethnicity :
Hispanic
Height:
5.0-5.5
Weight:
120
Reconstructive Procedure
  • Tissue Expander Implant

Patient is a 29 y.o. hispanic female who was diagnosed with Stage II breast cancer. Due to her young age she was recommended to have bilateral mastectomies. She had cosmetic augmentation with saline implants when she was 24 and is not pleased with how her breasts look. She requested implant based reconstruction. Due to her possible need for radiation, it was recommended to place tissue expanders first. Also due to the location of her cancer she was not a candidate for nipple sparing mastectomies.

Surgery 1

Photos after tissue expanders and expansion to her desired volume. It was determined that she did not need radiation but she did undergo chemotherapy. Prior to chemotherapy she met with a fertility specialist and underwent egg retrieval to allow for the ability for her to have children in the future.

Surgery 2

Photos after silicone high profile implant placement and fat grafting.

Surgery 3

Final photos showing reconstruction after nipple reconstruction and nipple areolar micropigmentation. She is looking forward to starting a family in the future and is so much happier with her reconstruction then her augmentation prior.

Patient Info
Age:
35
Gender:
Female
Ethnicity :
White
Height:
5.2
Weight:
150lbs
Reconstructive Procedure
  • Tissue Expander Implant

The patient is a 35 y.o. very active mother who was diagnosed with left Stage 2 breast cancer. She decided to have bilateral mastectomies and implant based reconstruction due to her busy lifestyle. She was found to require adjuvant chemotherapy. She underwent a two-stage reconstruction with tissue expander placement followed by silicone implant placement with revision of excess axillary skin. She decided that she was not interested in having a projecting nipple and therefore underwent 3-D tattoo/micropigmentation.

Surgery 1

Photos demonstrating tissue expanders in place after completion of expansion. The patient is interested in having silicone implants and having some of the redundant skin under her arms along her bra line to be removed.

Surgery 2

Photos showing surgery after silicone implant placement and revision of excess skin on the breast and into the axilla.

Surgery 3

Photos demonstrating final reconstruction with 3-D tattoo giving the illusion that a nipple exists without the projection. The patient enjoys being with a bra without the burden of trying to hide a projecting nipple.

Patient Info
Age:
42
Gender:
Female
Ethnicity :
Middle Eastern
Height:
5.0-5.5
Weight:
165lbs
Reconstructive Procedure
  • Mastopexy
  • DIEP Flap Surgery

Patient is a 41 y.o. lawyer from India who was diagnosed with advanced right breast cancer who underwent right modified radical mastectomy followed by chemotherapy and radiation. She presented for reconstruction 1 year after completion of radiation therapy and reported that she was having issues with wearing her prosthesis. She was interested in using her abdominal tissue for reconstruction. Photos demonstrating her preoperative photos.

Surgery 1

Photos after DIEP flap reconstruction to the right chest. She was interested in a mastopexy of her left breast and revision of her flank cone deformities.

Surgery 2

Photos demonstrating results after mastopexy of left breast for symmetry, revision of her flanks with direct excision and liposuction, and revision of her right breast reconstruction.

Surgery 3

Photos after right nipple reconstruction.

Surgery 4

Photos after right nipple areolar micropigmentation. The patient is enjoying traveling and maintains a busy law practice. She does report some weight gain and is working on maintaining her weight.

Surgery 5

Reconstruction after 4 years demonstrating continued symmetry. The patient continues to struggles with her weight but is working to loss some weight.

Patient Info
Age:
60
Gender:
Female
Ethnicity :
Black
Height:
5.6-6.0
Weight:
152lbs
Reconstructive Procedure
  • Revisional Breast Surgery
  • Tissue Expander Implant
  • Latissimus Muscle

The patient is a pleasant 60 y.o. african american female with a history of left breast cancer who had reconstruction with implants approximately 6 years prior at another institution. The patient presented with a left breast recurrence recurring removal of her implant to excise her recurrence and receive radiation therapy. Because the she required radiation therapy she was unable to have implant on the left side. She required a tissue from her back known as latissimus dorsi myocutaneous flap with an implant to reconstruct the left breast. The patient was unhappy with her reconstruction on the right and had revisional surgery with implant replacement to better match her left breast and give her a more natural appearing reconstruction.

Surgery 1

Photo demonstrating appearance of chest after excision of recurrence on left, implant removal and radiation therapy.

Surgery 2

Photo after surgery with tissue from the back (latissimus dorsi myocutaneous flap) with placement of a tissue expander. She is expanded to the size she wants to be and is interested in having a revision of her right breast reconstruction and replacement of the implant for symmetry.

Surgery 3

Photos demonstrating surgery after exchange of her left tissue expander for a permanent silicone implant and replacement of the right implant for a new silicone implant and revision of the mastectomy pocket to create a more natural and symmetric appearance.

Surgery 4

Photos after bilateral nipple reconstruction using local skin on the breast known as CV flaps. This was an in-office procedure. She did have a nipple reconstruction prior on the right breast however, she had lost projection and requested improvement and better projection.

Surgery 5

Final photos demonstrating nipple/areolar tattooing know as micropigmentation. She is pleased with her results and is happier with her new reconstruction and appearance.

Patient Info
Age:
32
Gender:
Female
Ethnicity :
White
Height:
5'5
Weight:
185
Reconstructive Procedure
  • Breast Augmentation
  • Mastopexy
  • Tissue Expander Implant
  • DIEP Flap Surgery

Patient is a 32 y.o. hairdresser and mother was diagnosed with advanced right breast cancer stage III who received neoadjuvant chemotherapy. A mastectomy was recommended and she wanted to use her own tissue but due to her need for post mastectomy radiation her tissue could not be used immediately. She requested a tissue expander to be placed so that she had something there while she was receiving her treatment. She wanted breasts that would match her body size and wanted more symmetry.

Surgery 2

Photos after tissue expander and radiation therapy demonstrating significant contracture and elevation of the tissue expander due to radiation.

Surgery 3

Photos after periareolar mastopexy and augmentation of the left breast.

Surgery 4

Photos after nipple reconstruction on the right reconstructed flap.

Surgery 5

Final photos demonstrating micropigmentation of the right nipple and areola. She is so happy with her new symmetric breasts and new body.

Surgery 6

Photos demonstrating results after 5 years. She continues to work as a hairdresser and continues to enjoy being a mother to her 8 y.o. girl.

Patient Info
Age:
52
Gender:
Female
Ethnicity :
White
Height:
5.0-5.5
Weight:
145lbs
Reconstructive Procedure
  • Mastopexy
  • DIEP Flap Surgery

The patient is a lovely 52 y.o. female who was diagnosed with inflammatory breast cancer. She underwent a modified radical mastectomy followed by chemotherapy and radiation therapy. She present for delayed reconstruction and was interested in a DIEP flap reconstruction. Photos demonstrating preoperative photos.

Surgery 1

Photos showing her results after DIEP flap reconstruction to the right chest. She was interested in more symmetry of her breasts and requested a mastopexy of the left breast.

Surgery 2

Photos demonstrating the free DIEP flap and mastopexy of the left breast for symmetry and revision of her flank cone deformities.

Surgery 3

Photos demonstrating nipple reconstruction.

Surgery 4

Photos demonstrating her final result with micropigmentation of her nipple and areola. The patient is now dating and feels extremely comfortable with her new body.

Surgery 5

Reconstruction after 5 years demonstrating consistent and continued great result. She continues to enjoy her new body.

Patient Info
Age:
30
Gender:
Female
Ethnicity :
White
Height:
5.4
Weight:
135lbs
Reconstructive Procedure
  • Nipple Sparing Mastectomy
  • Tissue Expander Implant

The patient is a beautiful 28 y.o. female who was diagnosed with BRCA2 and has a sister and mother who were diagnosed with breast cancer at a young age. She is engaged to be married and has requested bilateral prophylactic nipple sparing mastectomies and implant based reconstruction prior to her wedding in Mexico.

Surgery 1

Photos demonstrating bilateral tissue expanders in place and expanded to her desired volume.

Surgery 2

Photos demonstrating results after anatomic silicone implants in place and fat grafting for upper chest deformities and rippling of implants. She went on to get married in Mexico and looked amazing in her wedding dress.

Patient Info
Age:
34
Gender:
Female
Ethnicity :
White
Height:
5'6
Weight:
105
Reconstructive Procedure
  • Tissue Expander Implant

Patient is a 34 y.o. newscaster who was diagnosed with BRCA1 mutation and a family history of breast cancer who presented for prophylactic mastectomies. She is a mother of a 2 year old which she breast fed and is hoping to have more children but wanted to reduce her risk of breast cancer so desires removal of her breasts. She wanted more symmetric and fuller breasts. She chose implant based reconstruction with high profile silicone implants. These are her preoperative photos.

Surgery 1

Photos demonstrating tissue expanders in place and filled to her desired volume- she is interested in a slightly larger implant.

Surgery 2

Photos demonstrating high profile silicone implants in place. We discussed fat grafting to hide rippling of the implants and the upper chest depressions, however, she had minimal body fat to harvest for fat grafting so this was not performed.

Surgery 3

Photos demonstrating nipple reconstruction

Surgery 4

Final photos micropigmentation of the nipple and areola. The patient is extremely please and is about to deliver her second child. We discussed future fat grafting if she gains weight to assist with hiding her implant rippling .

Patient Info
Age:
62
Gender:
Female
Ethnicity :
White
Height:
5.0-5.5
Weight:
165
Reconstructive Procedure
  • Mastopexy
  • DIEP Flap Surgery

Patient is a 62 y.o. female who was diagnosed with left breast cancer and underwent a left total mastectomy. The patient struggled with her weight and was too obese for immediate reconstruction at the time of her mastectomy. She decided to have a gastric band procedure to lose weight and lost over 100lbs so that she could have reconstruction. She presented for delayed reconstruction using her abdominal tissue.

Surgery 1

Photos after reconstruction with a DIEP flap to the left chest. She was interested in better symmetry and a lifting of her right breast.

Surgery 2

Photos demonstrating revision of the patients flank cone deformities with direct excision and liposuction and mastopexy of the left breast.

Surgery 3

Photos demonstrating final results after nipple reconstruction and micropigmentation of the nipple and areola. She is so happy and continues to maintain a healthy weight and reports she is healthier than she ever has been.

Patient Info
Age:
40
Gender:
Female
Ethnicity :
White
Height:
5.6-6.0
Weight:
135lbs
Reconstructive Procedure
  • Tissue Expander Implant

The patient is a 40 y.o. mother and pharmaceutical representative who was diagnosed with right sided early stage breast cancer who is interested in bilateral mastectomies and implant based reconstruction. She has always wanted perky, fuller and larger breasts. She will underwent a two stage procedure with tissue expander placement followed by final implant. She chose this so that she could assist in determining the size of her final breast.

Surgery 1

Photos demonstrating tissue expanders in place and fully expanded to her desired volume.

Surgery 2

Photos demonstrating high profile silicone implants in place and after fat grafting to her upper chest deformities.

Surgery 3

Photos after nipple reconstruction with CV flaps.

Surgery 4

Final photos demonstrating micropigmentation for the nipple and areola bilaterally. The patient is very pleased with her results. She has some mild visual rippling of her implants which she may desire further fat grafting in the future to help improve.

Patient Info
Age:
49
Gender:
Female
Ethnicity :
Black
Height:
5.6-6.0
Weight:
170
Reconstructive Procedure
  • Mastopexy
  • Breast Reduction
  • DIEP Flap Surgery

The patient is a 49 y.o. african american school administrator who was diagnosed with advanced right breast cancer who underwent modified radical mastectomy followed by chemotherapy and radiation therapy. She presented for reconstruction 1 year after completing radiation requesting autologous reconstruction from her abdomen. She underwent DIEP flap reconstruction and a mastopexy of the left breast for symmetry.

Surgery 1

Photos after DIEP flap reconstruction to the right chest. She will need a slight reduction in size of the left breast and a mastopexy for symmetry.

Surgery 2

Photos after mastopexy with slight reduction of the left breast for symmetry and revision of the flank cone deformities.

Surgery 3

Photos after right nipple reconstruction.

Surgery 4

Final photos after micropigmentation of the nipple and areola on the right to match her native breast. She continues to lead an active life and is very pleased with her new breast and abdomen.

Patient Info
Age:
38
Gender:
Female
Ethnicity :
Hispanic
Height:
5'4
Weight:
150
Reconstructive Procedure
  • Breast Augmentation
  • Mastopexy
  • Tissue Expander Implant
  • DIEP Flap Surgery

The patient is a pleasant 38 y.o. hispanic female diagnosed with right breast cancer Stage II who presented for mastectomy and reconstruction. She was interested in using her own tissue but due to the concern for possible radiation (which would not be known until her lymph nodes and the pathology was evaluated after surgery), it was recommended to place a tissue expander to preserve her skin until her final pathology was reviewed. She was not found to need radiation and therefore went on to use her wown tissue from her abdomen. These are her preoperative photos.

Surgery 1

Photo demonstrating tissue expander in place prior to using her abdomen after being informed she would not need radiation.

Surgery 2

Photos showing DIEP flap reconstruction on right. The patient was interested in having larger and fuller breasts bilaterally therefore we recommended placing an implant under the reconstructed breast and a mastopexy/augmentation of the left breast for symmetry.

Surgery 3

Photos showing revision of the right breast reconstruction with implant placement and mastopexy augmentation of the left breast for symmetry.

Surgery 4

Photos showing nipple reconstruction of the right breast reconstruction.

Surgery 5

Final photos after micropigmentaiton of the right nipple and areola. She is very happy with her new breasts and enjoys wearing her bathing suit.

Patient Info
Age:
37
Gender:
Female
Ethnicity :
Black
Height:
5.6-6.0
Weight:
135lbs
Reconstructive Procedure
  • Tissue Expander Implant

Patient is a 37 y.o. hospital administrator diagnosed with left Stage II breast cancer who received neoadjuvant chemotherapy. She was interested in bilateral nipple sparing mastectomies and implant based reconstruction through an inframammary fold incision. Due to her possible risk for radiation therapy a two-stage reconstructive approach with placement of a tissue expander followed by implant was planned to assure she did not need radiation.

Surgery 1

Photos demonstrating tissue expanders in place and filled to her desired volume. She was found to not need radiation therapy. She was interested in high profile silicone implants and fat grafting for her upper chest deformities.

Surgery 2

Photos demonstrating implants in place. The patient was pleased with her results but wanted more fat grafting to her upper chest deformities and decided to go with larger implants.

Surgery 3

Photos demonstrating final reconstruction after further fat grafting and slightly larger implants in place. She could not be more pleased with her results and feels like she looks better than she did prior to her surgery.

Patient Info
Age:
42
Gender:
Female
Ethnicity :
White
Height:
5.0-5.5
Weight:
165lbs
Reconstructive Procedure
  • Tissue Expander Implant
  • Latissimus Muscle

The patient is a pleasant 42 y.o. female with a diagnosis of right sided breast cancer who was interested in having smaller breasts. She was also diagnosed with a BRCA mutation. She has decided to undergo bilateral mastectomy and she wanted implant based reconstruction. She unfortunately was found at the time of her mastectomy to have more advanced cancer then expected and required both chemotherapy and radiation therapy. Due to the radiation she required the use of her own tissue to reconstruct her breast on the right side.

Surgery 1

Photos demonstrating tissue expanders in place bilaterally and after radiation to the right chest. The tissue expanders have the same volume but due to radiation therapy the right tissue expander is elevated and in a tighter skin envelope than the left side.

Surgery 2

Photos demonstrating reconstruction on the right chest with a latissimus dorsi myocutaneous flap from the back and implant and an implant only on the left side. She chose saline implants to be placed. She also did not want to have any nipple or areolar reconstruction.

Surgery 3

Photos demonstrating 8 years out from her reconstruction with continued symmetry. The patients right breast has relaxed some and she may need a revision in the future. She is extremely pleased with her results and much happier with the size of her breasts.

Patient Info
Age:
32
Gender:
Female
Ethnicity :
Hispanic
Height:
5.4
Weight:
130lbs
Reconstructive Procedure
  • Tissue Expander Implant

This is a pleasant 32 y.o. female with an extensive family history of breast cancer with a mother who was diagnosed with breast cancer. She was diagnosed with DCIS of the right breast. She was interested in bilateral mastectomy with implants. She was interested in fuller and larger breasts.

Surgery 1

Photo demonstrating tissue expanders in place filled to volume slightly smaller than her desired volume. She requested slightly larger implants to be placed. She decided on high profile silicone implants.

Surgery 2

Photos after placement of high profile silicone implants with fat grafting to improve the contour depressions in the upper chest and to improve any rippling with the permanent implant.

Surgery 3

Photo demonstrating final reconstruction after nipple recreation with local tissue (CV flaps) and nipple/areolar micropigmentation.

Patient Info
Age:
45
Gender:
Female
Ethnicity :
White
Height:
5.6-6.0
Weight:
140
Reconstructive Procedure
  • Tissue Expander Implant
  • DIEP Flap Surgery

Patient is a 45 y.o. active female who was diagnosed with right sided breast cancer Stage II. It was recommended that she have a mastectomy and due to the location of the cancer she was not a candidate for nipple sparing mastectomy. She was interested in implant based reconstruction because she is very active and swims daily, so a tissue expander was placed at her first surgery. Unfortunately she was found at surgery to have more advanced breast cancer at the time of surgery. She then required chemotherapy and radiation after her surgery. In addition she had mastectomy skin necrosis and required debridement of her skin and she was unable to get full expansion of her tissue expander prior to radiation therapy. Because of her need for radiation she required her own tissue for her final reconstruction. Preoperative photos demonstrating bruising from her biopsy of her cancer.

Surgery 1

Photo of deflated tissue expander after radiation therapy. She agreed to using her own tissue for reconstruction.

Surgery 2

Photos after free DIEP flap reconstruction to the right chest and removal of her tissue expander.

Surgery 3

Photo after nipple reconstruction.

Surgery 4

Photos showing final results after nipple and areola tattooing. She is extremely pleased despite initially wanting implant reconstruction. She continues to swim on a daily basis.

Surgery 5

8 years after reconstruction with continued symmetry.

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