This is a 34 year old woman with a strong family history of breast cancer who is a carrier of the BRCA gene. She elected to undergo bilateral prophylactic nipple-sparing total mastectomies for cancer risk reduction. A single stage reconstruction with a direct to implant procedure was planned. Due to the moderate ptosis (sagging) of her breast, a periareolar incision pattern was designed to lift the breast at the time of reconstruction. Immediately following her mastectomies, she underwent bilateral reconstruction with placement of an acellular dermal matrix sling and a silicone gel implant. In the immediate postoperative period, she developed a small amount of skin loss of the right nipple, prompting an adjunct revision procedure.
Preoperative Images: Preop breast shape. Preoperative breast ptosis poses a challenging reconstructive problem in performing one stage implant reconstruction following nipple-sparing total mastectomies.
Postoperative Images: Postoperative results with overall volume symmetry. The patient was pleased with the results and no further treatment was necessary.
*Individual Results May Vary