Patient - Breast Reconstruction

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This lady in her 40's was diagnosed with cancer of the right breast. She was recommended to have a mastectomy and desired reconstruction. The plan was to place a tissue expander at the time of her mastectomy to be replaced later with a permanent breast implant.

Breast Reconstruction - Dr. Richard Bosshardt

She is shown before surgery.

Breast Reconstruction - Dr. Richard Bosshardt

She is shown after the surgery, with a tissue expander in place. Unfortunately, the pathology results made it necessary to recommend radiation therapy, so expansion was postponed until this was completed and she was fully recovered, almost 9 months later.

Breast Reconstruction - Dr. Richard Bosshardt

Her tissue expansion failed because the radiated tissues just did not tolerate the stresses of the expansion process and she was in danger of breaking down the skin over the expander and becoming infected. It was felt that we needed to switch to a technique using her own tissues. she is shown marked for a flap from the abdomen, called a TRAM  flap.

Breast Reconstruction - Dr. Richard Bosshardt

Here, she has undergone reconstruction with a TRAM flap which has worked very nicely. This was quite challenging in that she had multiple abdominal scars from prior surgery which necessitated placing the TRAM flap much higher on the abdomen than usual, giving her a horizontal scar at the level of the belly button rather than the typical "bikini" scar.


Altogether, she required a total of 5 operations to get to this point: 1. the original surgery 2. attempted revision of the tissue expander 3. TRAM reconstruction 4. nipple reconstruction and lift of the left breast 5. fat grafting to the reconstructed breast.

Breast Reconstruction - Dr. Richard Bosshardt

She is shown after nipple reconstruction and a lift of the left breast but before fat grafting. The latter is a way of correcting contour depressions in a reconstructed breast to smooth out the contour by using the patient's own fat, obtained by liposuction.

Breast Reconstruction - Dr. Richard Bosshardt

This oblique view shows the nice degree of symmetry acheived by the reconstruction, albeit not perfect.

Breast Reconstruction - Dr. Richard Bosshardt

This patient, ever a character, sent me this photograph of herself in Key West, on vacation. She said that she received many compliments on her reconstruction, of which she is very proud. It was a long and arduous process but worth it to her in the end.

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Tavares, FL
West of Waterman Hospital, just off US 441

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Dr. Richard Bosshardt has been recognized as a Florida Top Doctor for 2020.

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