Breast Reconstruction

After a mastectomy is performed because of breast cancer, the breast can be rebuilt. It is possible to use skin and fat from the abdomen. More commonly it is accomplished using implants. This is usually a two stage procedure. At the time the mastectomy is performed by a general surgeon, a temporary implant is placed by a plastic surgeon, which can be stretched by injecting fluid into it through the skin over the next few months. At a second operation a permanent implant, filled either with salt water (saline) or silicone gel, can be placed. If desired, the nipple can be reconstructed later.

---

Before	After
This 47-year-old was scheduled to undergo a bilateral mastectomy after developing cancer of her left breast. She chose to have a staged breast reconstruction, with the first stage at the time of her mastectomies. At the time of placement of her permanent implants, she had textured, shaped, cohesive-gel implants placed. She did not desire reconstruction of her nipples and areolae.

---

Before	After
This 40 year old with cancer of the left breast was advised to have a bilateral mastectomy. She was initially seen after having a lumpectomy, so her pre-operative pictures show a bandage and drain in her left breast. She chose to have a staged implant reconstruction. At the time of her mastectomies she had expander implants placed. They were then expanded during weekly office visits. At the time of her second stage reconstruction, she chose to have textured, shaped, saline-filled implants. She did not wish to have nipple reconstruction.

---

Before	After
This 37-year-old with cancer of the right breast was scheduled to undergo bilateral mastectomies. She chose to have staged implant reconstruction with the first stage performed at the time of her mastectomies. After undergoing expansion of the tissues, at the time of placement of her permanent implants, she chose to have saline implants placed. Textured, shaped saline implants were used. She did not request nipple and areola reconstruction.

---

Before	After
This 39-year-old with cancer of the left breast elected to undergo a staged implant reconstruction with the first stage at the time of her mastectomies. Her preoperative photos were taken immediately after her original biopsy was done, which is why there is visible bruising. Her postoperative photos were taken early after her final surgery. Textured, shaped, cohesive-gel implants were subsequently placed as her permanent implants. She declined nipple and areola reconstruction.

---

Before	After
This 52-year-old developed cancer of the left breast, and chose to have a staged breast implant reconstruction beginning at the time of her mastectomy. At the time of placement of her permanent implant, a textured, shaped, silicone gel implant was placed. She also had an enlargement of her opposite, right breast with a textured, round, moderate-profile silicone gel implant. She did not choose to have reconstruction of her nipple and areola.

---

Before	After
This 52-year-old had undergone bilateral mastectomies 1 year previously and initially declined reconstruction. She found that she had problems with her external prosthesis, and came in to inquire about breast reconstruction. She was 5'4" tall and weighed 185 pounds. She related that her breasts had been large. Her goal for reconstruction was to have smaller breasts, and she was not interested in having nipple reconstruction. She underwent a staged breast reconstruction with initial placement of expander implants, which were expanded during weekly visits. Her second stage breast reconstruction was done using textured, shaped cohesive-gel implants.

---

Before	After
This 67-year-old had a recurrent cancer of her left breast which required a left mastectomy. She underwent a staged reconstruction of the left breast with the final placement of a shaped textured silicone implant. At the time the permanent implant was place on the left, she also had a mastopexy, or lift, of the right breast. She did not request nipple-areolar reconstruction.

---

Before	After
This 50-year-old had undergone a lumpectomy and radiation of her left breast. She had a recurrence 7 years ago which required a mastectomy and at the time she had a staged implant reconstruction. She developed cancer of the right breast and it was recommended that she have a mastectomy on this side also. She was also concerned about the abnormal appearance of her previously reconstructed left breast, which was shriveled up and positionned too high on her chest wall. At the time of her mastectomy, she had first stage reconstruction of the right breast with placement of an expander implant. This was subsequently expanded. For her second stage breast reconstruction, she had a textured, shaped, cohesive-gel implant placed on the right side. The reconstruction of her left breast was revised. A latissimus dorsi musculocutaneous flap was moved from her back to provide extra tissue to cover a larger, and properly positionned implant. Because of the scarring from her previous radation therapy, the bottom of her left breast could not be stretched fully, so a slightly smaller textured, shaped, cohesive-gel implant was used on this side. Although the bottom of her left breast is not as full as the right, the tops of her breasts are symmetrical. Even in the early postoperative pictures, one can see that she is able to wear clothing and bathing suits without problem, had no limit to her activities, and is extremely pleased.

---