Patient - Breast Reconstruction

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This lady had very uneven breasts. She was diagnosed with breast cancer. Because of her size and degree of ptosis (drooping) I did not feel she was a good candidate for a nipple-sparing mastectomy  but those features made her a good candidate for a mastectomy using an "inverted T" incision, such as used in breast lifts and reductions, combined with salvage of her natural nipple/areola complex as a graft. 

Breast Reconstruction - Dr. Richard Bosshardt
Breast Reconstruction - Dr. Richard Bosshardt


All went well with her surgery but she experienced some breakdown of the lowermost skin from her mastectomy. I took her back to surgery 2 weeks after the first operation to revise this area. This was successful and she went on to expand nicely. Because she required lengthy chemotherapy, I deferred taking her back to replace her expander with a permanent implant until nine months later. Her implant is a Mentor MemoryGel smooth, round gel with a volume of 325 cc. This is a reasonable match with her other side albeit with a slightly more round contour and fuller upper breast. There are a few other issues. She lost nipple projection from her grafting procedure, a common occurence. She has an adherent indentation in the outer breast and a discrete bulge below this. These could be corrected with some fairly minor touch up work but she did not desire to do anything more, reserving that possibility for some time in the future. 

Breast Reconstruction - Dr. Richard Bosshardt
Breast Reconstruction - Dr. Richard Bosshardt

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