Claire
PROCEDURES
- Bilateral breast reduction pattern skin-sparing mastectomies with immediate prepectoral tissue expanders and dermal matrix
- Expander implant exchange with revision reconstruction and fat grafting
- 3-D nipple tattoo
Case Overview
Claire is a 53-year-old woman with dense breasts, left breast atypical hyperplasia, and a strong family history of breast cancer. Claire chose to have bilateral risk-reducing mastectomies without nipple preservation in response to a 38-percent lifetime risk of breast cancer development. Her breast reconstruction included staged expander implant reconstruction, fat grafting, and 3-D nipple tattoos.
Surgeon
Ron Israeli, M.D.
Before
After
Before Stage One
Claire is seen here before her skin-sparing mastectomies. She had large, ptotic breasts. One of her breast reconstruction goals was to emerge with smaller, uplifted breasts, which is why preoperative markings in the final image in this carousel reflect a breast reduction pattern. The breast reduction pattern also provides a more natural contour compared to transverse incisions, which are placed centrally across each breast.
Claire chose not to keep her nipples. Had she chosen nipple-sparing surgery, breast reduction with nipple preservation would have been done at a first stage, followed by nipple-sparing mastectomies and reconstruction at a second stage.
Two Months After Stage One
Two months after bilateral mastectomies and initial breast reconstruction with prepectoral (over the muscle) tissue expander implants with a dermal matrix, Claire was ready for second stage surgery. This planned procedure included tissue expander implant exchange, revision with skin excision, and fat grafting.
Markings Before Stage Two
These images show preoperative surgical markings for Claire’s planned expander implant exchange, fat grafting, and lower breast skin excision. The lower breast skin excision was designed to improve symmetry. Fat grafting corrected areas of concavity and softened the contours along the upper and inner edges of her implants.
Claire chose not to have nipple areola reconstruction and planned 3-D nipple tattoos as an alternative.
Five Months After Stage Two and Two Months After 3-D Nipple Tattoo
Three months after stage two surgery, Claire had her first stage 3-D nipple tattoo procedure. Here she is two months later with a well-healed prepectoral implant breast reconstruction and healed first stage 3-D nipple tattoos. The tattoos are still light in color with a second stage tattoo planned.
Final Reconstruction at One Year
These images show Claire one year after her mastectomies. Her reconstruction required first stage prepectoral tissue expanders and dermal matrix, followed by second stage revision, expander implant exchange, and fat grafting. Her 3-D nipple tattoos were completed in two separate office procedures once she was healed from the implant exchange surgery.
