Description:

Three month follow up from implant based breast reconstruction following bilateral nipple sparing mastectomy (double mastectomy). The implants are pre-pectoral (above the muscle) and an acellular dermal matrix was used. This patient also underwent nerve reconstruction to restore sensation to the nipple which is important for many women for intimacy and to prevent injury to the skin. This is a thin patient and the photos demonstrate some of the limitations in this patient population. On the side and three-quarters view a small amount of rippling is seen and a small crease or valley on the outer edge of the implant. While seen in heavier patients, these features are less noticeable in heavier patients because the mastectomy and adjacent skin is thicker and there is more fat to use for fat grafting to smooth away the contour irregularities. Another thing to consider is that the path of the reconstructed nerve is located on the outer edge of the breast. The need to protect the nerve limits some of the techniques used to smooth those areas. This patient is very happy and recognizes the limitations and compromises.