Patient - Breast Reconstruction

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This lady was diagnosed with cancer of the right breast. She chose to undergo a bilateral mastectomy and wished to have immediate reconstruction. I thought she would be a good candidate to have the breasts removed using a breast lift-type of incision, which leaves an upside down “T” scar, and save her natural nipple/areola complexes as grafts. The result, if successful, can leave a woman looking more like she had a breast reduction or lift, rather than cancer surgery. I made sure she understood that I could never perfectly duplicate her natural breasts. I scheduled surgery with her general surgeon to help him with this more complex mastectomy and to insert tissue expanders immediately. Once the expanders were in place and the incisions closed, I placed the nipple/areoa grafts back on her breasts. Because these are her own nipples/areolae, they look better than a fully artificial nipple/areola complex. 

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


She is shown six months after completion of her reconstruction. She did have one small setback. At the time of her mastectomies, I scanned the skin flaps to check the circulation in them and the left side showed an area of low blood flow. I chose to proceed and hope for the best, but this broke down and I had to take her back to surgery 8 days later to debride some dead skin and move a small skin flap from below the breast to cover that defect. Fortunately, this worked well.

Her tissue expansion went smoothly and I replaced her tissue expanders six months after her first surgery with a pair of 650 cc Allergan Natrelle Inspira Style SSF smooth, round gel implants. Her breasts are soft and her scars continue to fade away. While not the breasts she started with, these look and feel nice and she can wear normal clothing, bathing suits, etc. with no need for prostheses. She has no activity restrictions. 

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

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