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.
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.
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.
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