Breast Reconstruction

This lady who is well known journalist has had breast cancer on the left breast with a mastectomy. She was subsequently found to have early breast cancer on the right breast. She decided to have a skin-sparing mastectomy on the right breast and immediate reconstruction. In general reconstructive options that include the patients own tissues are better. She did not have enough abdominal tissue for TRAM flap reconstruction. After discussion of different options she decided she wanted reconstruction using saline filled breast implants and bilateral latisimus musculocutaneous flaps. The flaps were pedicled. In the back by pinching I evaluate how much skin I can safely remove. The reconstruction was done at the same time. Both musculocuaneous latisimus flaps were harvested. The reason to harvest the latisimus muscle flap in order to bring it around to the breast area and cover the saline implant was to give complete muscle coverage to the implant. That makes for a much more natural result. Furthermore the muscle has protective effects should the patient need radiation in the future. The reason to bring skin and fat together with the muscle is to replace missing skin from the mastectomies and also create a more natural breast mount and a new nipple-areolar complex. Saline breast implants were also used and were filled to 250cc bilaterally. You see the results of this patient after 3 months following her reconstruction. She was very happy and she decided not to proceed with tattoo of the new areolas, which is typically the last step of the breast reconstruction. I maintain contact with this patient as with most of my patients and I am pleased to mention that six years following this operation she is still cancer free!

This patient was referred to us for breast reconstruction following mastectomy for breast cancer on the right. She underwent right breast reconstruction with tissue expander, followed by removal and replacement with 500 cc High Profile silicone gel implant. In addition, she had fat harvesting and transfer to the right breast. In order to offer a symmetric appearance she also had left breast lift and augmentation. At the same time, she had abdominoplasty and liposuction of her flanks. The next step for her will be tattooing of her right breast to create nipple-areolar complex.