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.