Breast Reconstruction by Tissue Expansion / Implant Cases

This patient underwent bilateral staged reconstruction involving tissue expanders, followed by implants, nipple reconstruction, and tattooing after bilateral mastectomy.

Bilateral mastectomy for breast cancer can have potentially devastating psychological implications as far as physical appearance is concerned.

Top row photos show the patient before bilateral mastectomies. The bottom three views are taken after I completed bilateral tissue expansion, bilateral implant surgery, bilateral nipple reconstruction, and pigmentation.

In my practice, every step is critical. It is the only way to achieve these outstanding outcomes time and time again.

Women who have unilateral (single sided) breast cancer will often choose to undergo bilateral mastectomies. What seems at first to be aggressive treatment may actually be the truest form of conservative treatment for life, body, and mind preservation.

This patient had bilateral tissue expanders replaced with bilateral implants, and subsequent nipple reconstruction. Scars will fade, revealing a natural looking small B cup breast- a personal triumph for this well-educated women.

With plans for bilateral mastectomies, this patient elected for a staged approach with tissue expanders, later replaced with implants and subsequent nipple reconstruction with pigment tattooing. Another fine cosmetic outcome (A cup to full B cup).

This patient presented with a plan for bilateral mastectomy.

Top Row: Pre-op

Bottom Row views: After completion of various stages of implant reconstruction. I achieved successful camouflage of a potential mastectomy defect and a very nice aesthetic outcome.

This case focuses on two important issues in breast reconstruction: how to gain symmetry in single-sided mastectomy and nipple reconstruction.

Top row: Before mastectomy

Center row: With tissue expander in place

Bottom row: After complete reconstruction which included a lift on the right side, implant replacing her expander on the left side, and nipple reconstruction.

This case demonstrates the importance of the second-stage procedure in creation of proper breast aesthetics. There is often too much emphasis on marketing and gimmicky notions of single-stage expander implant devices or single-stage implant reconstruction without the use of flaps (possible with TRAM or latissimus). Expanders work to stretch the skin and muscle. Bottom row of photos: Aesthetically-pleasing breasts after total mastectomy.

This patient underwent a mastectomy for unilateral (single-side) left breast cancer.

Top row views: Pre-op

Bottom row views: After left mastectomy, I performed reconstruction with implant, nipple reconstruction, tattooing, and an opposite breast symmetry procedure (breast augmentation). Opposite breast surgery is often required to balance both sides.

A very nice aesthetic outcome in a challenging case.

In order to camouflage a mastectomy defect, a modest increase in breast size is usually required when undergoing mastectomy for breast cancer. The patient is shown after bilateral mastectomy and bilateral tissue expander reconstruction, later replaced with implants and bilateral nipple reconstruction with micro-pigmentation of the reconstructed nipple and areola. When the scars fade, she will look as if she has had cosmetic breast enhancement, rather than potentially disfiguring mastectomy surgery.

Cases in which a patient had a previous mastectomy without reconstruction can be complicated. They may have found breast cancer in the opposite breast or, simply elected to later remove the opposite breast due to growing fear and anxiety about further cancer development.

In her pre-op views, she is shown several years after her right mastectomy and just prior to the left mastectomy. In this case, the potential for dramatic asymmetries exists. Post-op views show successful, pleasing results after bilateral reconstruction.