Patient - Breast Reconstruction

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This very youthful, attractive lady in her early 60's presented with the worst surgically disfigured breasts I have ever seen. This was the result of unsuccessful attempts at breast augmentation and salvage of complications by three different surgeons. Her first surgeon was not a plastic surgeon at all, but rather a general surgeon who placed a pair of gel implants above the muscle. They became hard very quickly. She went to a plastic surgeon in Orlando who tried twice to salvage her augmentation and eventually removed her implants at a third operatoin. Her breasts were so scarred that she went to Miami to see a plastic surgeon there for fat grafts to her breasts. These failed as well. Her breasts were not just terribly disfigured; they were so scarred that I was unsure if anything could salvage them. I have never seen breasts with more scar tightly adhering them to her chest wall. She was too thin for reconstruction with her own tissues and this would have been major surgery in any event. I offered to try to release her scars and place a tissue expander, but cautioned her that this would be a major challenge, and might fail. 

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


As expected, her surgery was extremely difficult due to all the scar. I could not salvage her right nipple and part of the areola. Her expansion  went slowly but well and I was able to get her to a reasonable volume with no hiccups. Four months after her first surgery, I replaced her expanders with a pair of Allergan Natrelle Style SCF cohesive smooth, round gel implants. I placed a 520 cc implant on the right and a 485 cc on the left. Four months after that, I took her back to surgery for a slight revision/lift of the left breast and reconstructed her right nipple using a piece of the prominent left nipple, a procedure called nipple-sharing, which worked nicely. Three months later I finished everything by tattooing on some color for her right areola. Her breasts, while not perfect, are soft and have acceptable contour and symmetry. She can wear whatever she likes in the way of bathing suits and tops without a prosthesis or feeling self-conscious. 

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

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