Before & Afters - Breast Reconstruction

This is a middle-aged lady that was diagnosed with right breast cancer.  She underwent a right mastectomy with sentinel node biopsy. Ultimately she has the left breast removed for symmetry and presented for delayed bilateral reconstruction. She underwent expander, Alloderm reconstruction.  The expanders were exchanged for permanent implants at a later date.  In the interim, she underwent an abdominoplasty and ultimately had her nipple areolar complexes tattooed.  She has gotten a very nice result from her reconstruction. The breasts are nicely shaped and symmetrical.  Her abdominal contour is much improved.  

 

Photos submitted by Dr. Owen-43756

This lady was seen for consideration for prophylactic mastectomies.  She has multiple family members with breast cancer.  Subcutaneous mastectomies are done to diminish the risk of developing breast cancer.  They maintain the skin and the nipple areolar complex but remove the breast parenchyma from inside the breast.  This can be done through several scars.  This lady’s were done through a radial excision.  She underwent the operation to remove the breast tissue and went through a staged reconstruction with a tissue expander and Alloderm in the 1ststage.  Alloderm is a product made from human skin that acts as an internal bra to maintain the shape of the breast and keep it soft.  She underwent a series of expansions to fill the expander implant to the desired size and then had a 2ndoperation to replace the expander for a permanent implant.  We also used some fat to correct some asymmetry in the upper poles of the breasts. She is a good two sizes larger than her pre-operative size.  The nipple areolar complexes are in good position.  The breasts are soft and feel natural.  The scars are still red but are flat and soft and should continue to improve over the next year.

 

Photos submitted by Dr. Owen-53876

 

This is a 48YO lady who was diagnosed with invasive breast cancer of the left breast. Preoperatively, she has large and droopy breasts.  

 

We treated her with bilateral mastectomies and breast reconstruction.  As you can see from her pictures, she actually looks better after she has undergone her breast reconstruction than what she looked like preoperatively.  

 

It is now possible to reconstruct breast cancer patients so they do not look like they have their body mutilated.

 

Insurance will usually pay for the reconstructive procedures.

 

Photos submitted by Dr. Feagin-53524

This is a black female who had right breast cancer and is s/p mastectomy.  Surgical margins were clear.  The lesion was quite small and found on mammogram.  There was no lymph node involvement.  The caner did not require chemotherapy or radiation.  She was seen to discuss her options for reconstruction.  We discussed her various options, both implant and autogenous type reconstructions. She was an excellent candidate for an autogenous reconstruction which we did.  The 1stoperation was the tram flap which transferred skin and fat from her lower abdomen to create a right breast mound.  She had a small amount of flap loss laterally that required a small revision.  Subsequently she had nipple areolar reconstruction on the right and a lift on the left side.  Her post op photographs are about 9 months after the final series of operations. Symmetry is good as far as size and projection of the breasts.  She has some deficit in the upper, outer pole of the reconstructed right breast that would benefit nicely from fat injections.  She also has very prominent axillary breast tissue which if excised would create a more aesthetic reconstruction.  Her breast size before surgery was a D cup and she is now a large B/small C.  

 

Photos submitted by Dr. Owen-52826

This patient was found to have a lobular carcinoma in situ on her left breast. This showed up on a routine mammogram. She had frequent mammograms and multiple biopsies on the left side. She had a pronounced family history of breast cancer. She was given multiple options and opted for bilateral mastectomies with immediate reconstructions. Because the tumor was small and deep, it was an option to do her mastectomy as a nipple sparing mastectomy, which was done through periareolar incisions with lateral extensions. Her mastectomy was done by Dr. Scott Robbins. At the completion of the mastectomy, Strattice dermal matrix was placed to serve as an internal bra with placement of tissue expanders which were expanded over time to the appropriate volume. A second operation was carried out to replace the tissue expanders with a permanent implant, remove the breast tissue beneath the nipple areola complexes, and revise Strattice on both sides. She has gotten a very nice result. She has maintained pretty much her breast size and shape and her own nipple areola complexes. She had negative margins on all of her resections and remains cancer free to date.

Photos submitted by Dr. Owen-49910

This is a patient that had prior breast implants and was found to have a tumor in the nipple areolar complex on the right breast.  She opted for bilateral mastectomies with immediate reconstruction that was done with Alloderm and tissue expanders subsequently exchanged for permanent gel implants using the Natrelle textured anatomic implant.  The implants were 655cc.  She is shown following the implant exchange operation.  She has opted not to pursue the nipple areolar reconstruction.  The shape of the breast has improved with better upper pole fullness and better projection.  The droopiness has improved.  She has a nice, feminine figure in clothing.  The nipple areolar reconstruction could be done at any time with a smaller operation or with tattooing. 

 

Photos submitted by Dr. Owen-#52317

This lady had a significant family history of breast cancer.  She had genetic testing done that demonstrated that she was a carrier of the BRCA gene which put her at a higher risk for developing breast cancer in her lifetime.  After discussing her options with her general surgeon, she opted for bilateral prophylactic mastectomies, bilateral oophorectomies, and immediate breast reconstruction.  She was an excellent candidate for the nipple sparing mastectomy which she had done.  At the same setting, she had her ovaries removed and I completed the surgery with placement of dermal matrix to form an internal bra followed by placement of tissue expanders.  She was a large B/small C preoperatively and wished to be a full C with some upper pole fullness post completion of the reconstruction.  Using tissue expanders allowed us to do that and give her a view of what she would ultimately look like.  Over the ensuing months she came to the office for fill and once we were at the volume she was happy with, we returned to the operating room and replaced the tissue expanders for permanent implants.  She is now shown in post operative photographs about 9 months out after we began this process.  She has a fuller upper pole contour, larger cup size, and has maintained good breast symmetry.  This operation allowed her to keep her own nipple areolar complex and minimize the extent of the scarring. 

 

Photos submitted by Dr. Owen-#51827

This patient had numerous family members with breast cancer, had herself numerous breast biopsies, and had genetic testing that indicated a very high risk for developing breast cancer in her lifetime. She opted for bilateral prophylactic simple mastectomies with immediate reconstruction. The mastectomies were done through a wise pattern (breast reduction) excision removing redundant skin on the breasts in addition to the underlying breast parenchyma and reconstruction with implants and biologic dermal matrix suspension internally. She subsequently had reconstruction of the nipple areolar complex, and at some point, she may opt to have some tattooing done of the nipple areolar complex. She presently is a large C/small D. The breasts are significantly better shaped than that of her preoperative appearance. Her breasts are soft and symmetry is excellent.

 

Photos submitted by Dr. Owen-#48229

This is a middle aged lady who had a left mastectomy for breast cancer about 8 years ago and wished now to begin reconstruction. She opted for an implant type reconstruction. Through a series of operations, she underwent reconstruction of the left breast with a tissue expander and Alloderm dermal replacement, nipple reconstruction, and ultimately a mastopexy on the right side for symmetry. She has gotten a nice result with soft reconstructed breasts and good symmetry in clothing. She decided not to have her areolars tattooed.

 

Photos submitted by Dr. Owen-#47398

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