Patient - Breast Reconstruction

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Before

This elderly patient had her right breast removed in 1987 for cancer and had the breast reconstructed using skin and fat from her abdomen (TRAM flap). Later, she had the nipple reconstructed and an implant place in the left breast for symmetry. The left breast became very hard due to contracture of the scar capsule that form around all implants. I attempted to revise this in 2011 by the contracture reoccurred. She was able to accept this but in 2023 with deflation of her implant. This is more common in implanted breasts that become firm or hard. With two failures due to contracture, I had to take a different tack. I proposed a two-stage surgery to place a tissue expander and later replacement of this with a new implant. She wanted to go ahead with this. 

The collapsed left implant severely distorted the breast due to scar tissue. 

After

When I removed her old implant and inserted the tissue expander, I partially covered the expander with a sheet of material made from human skin. This material becomes incorporated fully into the implant pocket and is very effective in preventing contracture and firm breasts. I took her final photos 3 months after the surgery and her left breast has remained very soft and nicely shaped, as well as a good match with her right breast. This should hold up from this point on.