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

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

 

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

This is a 32YO lady from Destin, Florida.  She is interested in some cosmetic improvement of her breasts.  She has lost superior fullness of the breasts and they are droopy.  Her nipples are much lower than she desires.  The right breast is a larger breast and more droopy.  She underwent a mastopexy with silicone implants.  The nipples are now pointing more towards the front rather than pointing down.  She now has some superior fullness and shape to the breasts.  

 

This procedure is done through outpatient.

 

Photos submitted by Dr. Feagin

This is a lady that desired some cosmetic improvement of her droopy breasts.  She also wanted more superior fullness.  The nipples were pointing toward the floor and she wanted them uplifted and pointing upwards.  

 

She underwent a mastopexy with silicone implants.  Her breasts are now reshaped with more fullness and much less droopiness.  The nipples are now in good position.  

 

This procedure is done at the hospital in outpatient.  

 

Photos submitted by Dr. Feagin

These are pre and post op photographs of a young lady that has had 3 children.  She is about 110lbs.  She weighed as much as almost 200lbs. with her pregnancy.  After the birth of her children, she was barely an A cup and wished to be a C cup with some upper pole fullness. Her breasts were basically empty socks with skin on top of her chest wall, ribs, and musculature. She is an athlete and her skin was not very strong.  We opted for a smaller implant that we thought would not be problematic during her athletic endeavors and would also have a better chance of holding over time in light of her poor skin quality.  She underwent an augmentation/mastopexy using 310cc silicone implants.  Post operatively she is a C cup and the nipple areolar complexes remain sensate. The breasts are symmetrical and soft. The scars are flat and soft and the color continues to improve.  She has gotten a very nice result and is quite pleased.

 

Photos submitted by Dr. Owen

This is a middle-aged lady that has had several children.  She got as large as a C with her pregnancy.  She wished her breasts back up on her chest and wanted to be a D cup. She is a B cup at present.  She underwent an augmentation/mastopexy with gel implants.  We used 405cc on the right side and 405cc on the left.  She required a superior crescent mastopexy on the right side and a full, wise pattern mastopexy on the left.  Implant sizes were agreed upon with trials in the office prior to her surgery. Her breasts are now symmetrical and project nicely.  She is a large C to small D in some bra lines.  

 

Photos submitted by Dr. Owen

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

This is a middle aged lady who wished some improvement in her chest.  She is small and weighs less than 120lbs.  She initially was here and thinking that she wished only to have a mastopexy.  She had seen a “cosmetic surgeon” that had recommended very large implants.  The implants would not have addressed the problems and the size that was recommended was out of line for her small frame.  In the consultation it was determined that she did wish more projection i.e. an implant and did want some more fullness in the upper poles.  She also wished some improvement in the asymmetry.  In addition to some asymmetry in the breasts themselves, she had some body asymmetry on the whole left side of her body.  It is higher than the right i.e. the shoulder, inframammary crease, and the hip.  I did ultimately operate on her and did a wise pattern mastopexy with a 195cc on the right and a perioareolar lift on the left with a 255cc implant.  This got her breasts more symmetrical.  It gave her the upper pole fullness that she desired. Her breast size is appropriate for her small frame.  She has maintained sensation in both nipple areolar complexes.  Her scars are flat and soft and will continue to fade with time. Post operative photos are two months out.  She has gotten a very nice result and is very pleased with the outcome.

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.

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4300 West Main Street, Doctors Tower, 4th Floor, Dothan, AL 36305

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