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Prophylactic Mastectomy Reconstruction Patient 4

This is a 33 year old woman who presented as a carrier of the BRCA gene and a strong family history of breast cancer. She elected to undergo bilateral prophylactic mastectomies with immediate placement of tissue expanders with acellular dermal implants. Following tissue expansion, she underwent exchange of the expanders to permanent silicone gel implants. After her exchange to permanent gel implants, she underwent nipple reconstructions and adjunctive fat grafting to the tissues surrounding the implants. She is shown three months are final nipple areola tattooing.

Preoperative: Her preop breasts. The patient wears a 34 B cup bra.
Postoperative 1: Her breasts following expander placement and exchange to permanent gel implants.
Postoperative 2: Her breasts following nipple reconstruction and fat grafting to the areas of the breasts adjacent to the implants in the upper poles of the breasts.
Postoperative 3: Completion of the nipple reconstruction with areolar tattooing.

This is a breast reconstruction case using tissue expanders, aceullular dermal matrix, and permanent implants or TRAM Flaps. The mastectomy was performed via a “Wise Pattern” Skin excision similar to a breast reduction. This approach is used in woman with larger breasts to reduce the amount of excess skin, giving a much improved shape and contour.