Patient - Breast Reconstruction

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Before

This lady underwent bilateral total mastectomy for precancerous changes in her breasts over 15 years ago. She had reconstruction using tissue expanders and saline implants. A single revision was done years later for a leaking implant and new gel implants were inserted. These were 650 cc. Over the years, she felt that her implants were too small for her frame, she did not have good projection of her breasts, and the left implant had slid down causing what is known as "bottoming out".

She shown as she presented with breasts that were too small and very asymmetrical.

After

I removed her implants and replaced them with new tissue expanders. I also used Alloderm sheets in each pocket to facilitate the expansion process and prevent contracture of her pockets later. Expansion was done to a volume of 960 cc on the left and 1010 cc on the right. I later replaced the expanders with Allegan Natrell Style 20 gel implants, both 800 cc. Her proportions were much better, projection was better, and symmetry was much improved. She does have some visible upper pole rippling on the left, even with gel implants. She was OK with this.