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.