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This woman chose the implant method of breast reconstruction on her left breast, and had her right (native) breast augmented to attain symmetry.
This lady had previously undergone mastectomy of the right breast for cancer. She also had treatment with radiation. Because of the radiation treatment, reconstruction with tissue expansion was not possible, and we opted to perform reconstruction with a latissimus flap from her back. She also desired to make her left breast somewhat larger, if possible.
This woman has chosen implant reconstruction for her right breast, and mastopexy for her left breast to attain symmetry.
This lady presented after mastectomy and radiation therapy. The image on the left shows the early result after latissimus breast reconstruction. The radiation damage to her skin is shown by the brown skin changes (black arrow); the non-radiated skin from her back (white arrow) makes up the inferior pole of her breast. The image on the right shows her result after other side breast reduction, and nipple/areola reconstruction.
This 41 year old woman presented after right mastectomy for breast cancer. Delayed reconstruction was accomplished with tissue expansion, followed by permanent implant placement (silicone gel implants), and nipple/areola reconstruction under local in the office. Her left breast was augmented at the second stage procedure for symmetry.
This is a 33 year old lady who presented after right breast lumpectomy and radiation for breast cancer. She was concerned because of her breast asymmetry; she also was unhappy with her breast ptosis. To address these issues, we first placed a tissue expander on the right side, and at the same time did a left breast mastopexy (lift). Five months later, after the expansion process was completed she was taken back to the operating room where a permanent implant was placed on the right (after removing the tissue expander)—a mastopexy was performed on the right breast at the same time.
Surgery in a radiated field (such as the right breast in this situation) has a much higher complication rate—there is a higher incidence of contracture of the breast, or wound healing problems. After mastectomy, a flap method is typically my favored approach to address breast mound reconstruction. The situation after lumpectomy is difficult, because not that much volume is needed. This patient understood prior to the 1st surgery that this technique might not work, and ultimately might have needed to utilize a flap to salvage the situation.