Breast Reconstruction
Gallery
Patient 1
Breast Reconstruction: Nipple-Sparing Mastectomy
This is a 49 year old female diagnosed with right sided LCIS with a strong family history of breast cancer. Dr. Nini performed a bilateral nipple-sparing mastectomy with bilateral tissue expanders and used an Acellular Dermal Matrix inner liner in the pre-pectoral plane. She then had full profile highly cohesive silicone implants placed with bilateral fat and stem cell grafting. Photos were taken at 4 months.
Procedures performed: Tissue Expansion, Implants
Patient 2
Breast Reconstruction: Nipple-Sparing Mastectomy
This is a 52-year-old female diagnosed with left-sided breast cancer. Dr. Nini recommended a skin envelope reduction mastectomy with tissue expander-based reconstruction. She then had highly cohesive full profile 560 cc implants placed bilaterally. To complete her reconstruction, bilateral nipple reconstruction with areolar tattooing was performed. Photos were taken at 9 months.
Procedures performed: Skin Envelope Reduction Mastectomy With Tissue Expander Based Reconstruction
Patient 3
Breast Reconstruction: Nipple-Sparing Mastectomy
This 51-year -old patient presents to the office with a diagnosed left breast cancer. She is 5’3 and weighs 107lbs. After consultation, she has decided to pursue bilateral skin and nipple sparring mastectomies with immediate reconstruction. After tissue expansion was complete Dr. Wey placed 275cc smooth round high profile implants submuscularly. Photos at 4 months.
Procedures performed: Nipple-Sparing Mastectomies and Expander Based reconstruction
Patient 4
Breast Reconstruction: Nipple-Sparing Mastectomy
This is a 30-year-old female who presents in the office for a discussion of prophylactic mastectomy and immediate reconstruction. She is known to have the BRCA 2 gene mutation and a strong family history of breast cancer. The procedure performed was bilateral skin and nipple sparring mastectomies with tissue expanders followed by placement of silicone implants. Photos at 6 months.
Procedures performed: Nipple Skin-Sparing Mastectomies and Expander Based reconstruction
Patient 5
Breast Reconstruction: Nipple Skin-Sparing Mastectomy
This is a 37-year-old female who presents with multi-focal right breast cancer. She decided to proceed with bilateral mastectomies and immediate nipple and skin-sparing reconstruction with Dr. Naveen Ahuja. After bilateral tissue expansion was complete, Dr. Ahuja used Mentor 550cc smooth round high-profile silicone implants placed submuscularly. Photos taken 10 months after implants were placed.
Procedures performed: Nipple-Sparing Mastectomies with Expander Based Reconstruction
Patient 6
Breast Reconstruction: Direct-To-Implant
This patient had bilateral cosmetic submuscular breast implants placed previously years ago and now needs reconstruction after bilateral prophylactic mastectomy. Dr. Wey determined she was eligible for nipple-sparing mastectomy and reconstruction with implants. Because the previous implants already provided the “tissue expansion,” this is the perfect setting for a new single-stage “direct-to-implant” reconstruction which was performed all in a single surgery alongside the mastectomies.
Procedures performed: Single-stage Direct-to-Implant Breast Reconstruction
Patient 7
Breast Reconstruction: Nipple Skin-Sparing Mastectomy
This 48-year-old was recently diagnosed as BRCA 1 positive and had a strong family of breast cancer. She decided to proceed with bilateral risk reduction mastectomies and immediate reconstruction. Dr. Nini recommended nipple skin sparing mastectomies and expanders. After the tissue expansion process, he placed Natrelle 550cc high-profile silicone implants submuscularly to complete her reconstruction and make her just a bit larger!
Procedures performed: Prophylactic Nipple skin-sparing mastectomies and Expander reconstruction
Patient 8
Breast Reconstruction: Nipple Skin-Sparing Mastectomy
This 42-year-old woman was diagnosed with a left breast cancer. She received chemotherapy prior to her surgery. Since a nipple skin-sparing mastectomy was planned, the breast surgeon performed a biopsy of the tissue beneath the nipple to make sure that it was free of tumor cells. As a result, she experienced significant bruising which can be seen in her preoperative photographs. Two weeks later tissue expander was placed in the sub-pectoral position and filled to 300 cc. Three months later, the tissue expander was removed and placed with an anatomically shaped 370 cc Mentor cohesive gel breast implant. A small elevation of the right nipple-areolar complex was performed for symmetry. Her postoperative photographs were taken 6 months after the second stage was completed.
Procedures performed: Sub-pectoral breast reconstruction with anatomical implant
Patient 9
Breast Reconstruction: Nipple-Sparing Mastectomy
This 48-year-old was referred to Dr. Nini with a newly diagnosed right invasive ductal carcinoma. She has decided to undergo bilateral mastectomies with immediate tissue expander reconstruction. A nipple skin sparing mastectomy was planned. Her preoperative photographs demonstrate a resolving bruise on both breasts. Dr. Nini’s protocol for patients having nipple sparing mastectomy calls for biopsies of the tissue directly beneath the nipples prior to mastectomy. This ensures that there are no tumor cells contaminating the area just below the nipples which are going to remain. This gives us a level of confidence that the nipple skin sparing technique is safe for that particular patient. Using a Natrelle style 410 anatomically shaped silicone implant, we completed her reconstruction. Notice how natural her breasts appear. Her photos were taken at one year.
Procedures performed: Sub-pectoral breast reconstruction with anatomical implant
Patient 10
Breast Reconstruction: Nipple-Sparing Mastectomy
This 43-year-old was diagnosed with DCIS in the right breast, but because of a past treatment with radiation therapy for Hodgkin’s disease, bilateral mastectomy was recommended by the breast surgeon. Because of the relatively small size of her breasts, she was an ideal candidate for a nipple skin-sparing mastectomy with an incision placed in the inframammary fold. Bilateral tissue expanders and acellular dermal matrix were used in the sub-pectoral position. Approximately 3 months later the expanders were removed and replaced with Allergan style 410 anatomically shaped cohesive gel silicone implants 335 cc. Her preoperative photographs demonstrate the bruising related to biopsies that were performed beneath the nipple areolar complex to ensure that there are no tumor cells in this area. This is part of our protocol and is performed on every nipple skin sparing patient approximately 2-3 weeks prior to the mastectomy. It provides a level of assurance that the nipple skin sparing mastectomy is safe for that particular patient. Her postoperative photographs were taken approximately 1 year after completion of the reconstruction.
Procedures performed: Nipple skin-sparing mastectomy with anatomic silicone breast implants
Patient 11
Breast Reconstruction: Latissmus Dorsi, Expanders, and Breast Implants
This 43-year-old woman presented to Dr. Nini with a newly diagnosed left breast cancer. She had previously been treated for right breast cancer many years earlier by lumpectomy and radiation. The asymmetry and retraction due to radiation scarring is evident in her preoperative photographs. In general, most plastic surgeons feel that a history of radiation precludes the use of silicone breast implants. However, there are several techniques that we can use to separate the implant from the radiated tissue and still achieve an excellent result. In this patient, we decided to recommend a latissimus dorsi reconstruction on the right side and an expander based reconstruction on the left. After the expansion, the expanders were replaced with a 500 cc smooth round high profile Mentor implant on the right side and a 550 cc smooth round high profile on the left side. The last 2 photographs demonstrate the softness of the reconstruction as well as the short hidden scar used to harvest the muscle. Bilateral nipple reconstruction and areola tattooing was also performed.
Procedures performed: Breast reconstruction with latissimus dorsi, expanders and silicone implants
Patient 12
Breast Reconstruction: Nipple-Sparing Mastectomy
This is a 25-year-old woman who had a right lumpectomy and radiation for a previous breast cancer. She then required bilateral mastectomy and full reconstruction. We were able to preserve both nipples using a new a procedure called “nipple-sparing mastectomy”. The reconstruction on her left side consisted of a tissue expander followed by a silicone implant after three months. Because of the radiation on the right side, a latissimus flap was required in order to smoothly fill out the severe dent resulting from the prior surgery and radiation.
Procedures performed: Latissimus Flap, Tissue Expansion, Implants
Patient 13
Breast Reconstruction: Nipple-Sparing Mastectomy
This 42-year-old woman presented with a right breast cancer. You can see from her preoperative photographs that a chemotherapy infusion port was placed on her left chest wall. What is unusual, or beautiful about this, is that the breast surgeon placed the port in a very inconspicuous position. The postoperative photographs show how nicely the incision has healed. But more importantly, the scar is not the center of the chest, under the collarbone, for everyone to see forever. That scar is the one that the patients complain to me about the most. Her reconstruction was carried out like many other nipple skin-sparing mastectomies and immediate reconstructions; it was a two-stage procedure with the expander completely wrapped with acellular dermal matrix. What’s different however, is that a Natrell style 410 anatomically-shaped silicone implant was utilized and her own fat and stem cells were grafted the upper poles of the breast mounds. Her results are shown 7 months after completion of her reconstruction.
Nipple skin sparing mastectomy, anatomically-shaped silicone breast implants, autologous fat grafting
Patient 14
Breast Reconstruction: Nipple-Sparing Mastectomy
This is a 37 year-old female diagnosed with breast cancer. She had a bilateral nipple sparing mastectomy with incisions made in the inframammary folds with placement of tissue expanders. She then had 550 cc high profile smooth implants placed bilaterally by Dr. Ahuja. She has some persistent rippling of the implants. She was offered fat grafting to correct this, however, it does not bother her and disappears when she puts on her bra.
Procedures performed: Nipple Skin Sparing Mastectomies and Expander Based reconstruction
Patient 15
Breast Reconstruction
This is a 46-year-old woman with an invasive right breast cancer. She had requested bilateral mastectomy and immediate reconstruction. Although she had desired a nipple skin sparing mastectomy, her case was complicated by a previous breast reduction, the scars are evident in the preoperative photographs. Working with her oncologic surgeon, we decided to utilize the breast reduction incisions to perform the mastectomy and reconstruction. What is particularly interesting, is that I grafted her native nipples onto the reconstructed breast mounds at the time of mastectomy. She underwent the usual course of expansion and the second stage with the expanders were replaced with 600 cc Allergan high profile silicone gel implants. Although her nipple tattoos have faded a bit and are easily re-colored, her reconstruction is an excellent approximation of her preoperative appearance. Her photos were taken at one year.
Procedures performed: Expander Breast Reconstruction, silicone implants, nipple grafting
Patient 16
Breast Reconstruction: Nipple-Sparing Mastectomy
This is the case of a 54-year-old woman who was previously treated for breast cancer on the right side by lumpectomy and radiation. After multiple right breast biopsies and severe radiation damage, the right breast became lumpy, hard, painfully distorted. It was also suspicious for cancer recurrence. Dr. Nini recommended biopsy and a complex reconstruction consisting of nipple skin sparing mastectomy on the right side with latissimus dorsi coverage of a tissue expander. At the same procedure, a balancing left breast reduction was performed. At the second stage, fat based stem cells were harvested and prepared for injection throughout the soft tissue of the right breast. The right tissue expander was replaced with a silicone breast implant. Her photos are taken at the one-year anniversary. As you can see, the distortion and lumpiness have significantly improved. The stem cells have reversed much of the damage caused by the radiation. Her breast is now soft and no longer painful. In addition, her natural nipple was saved and she has much better balance between the breasts.
Procedures performed: Nipple nipple-sparing mastectomy with Implant Reconstruction, Stem Cell Transfer, and Balancing Reduction
Patient 17
Breast Reconstruction
This patient presents to the office for immediate breast reconstruction following mastectomies. She is 51 years old, 5’3, and 107 lbs. Diagnosed with left invasive lobular cancer, she has decided to pursue bilateral nipple and skin sparring mastectomies. After tissue expansion was completed, we placed 275cc high profile silicone gel implants in the subglandular position. Photos at 4 months.
Procedures performed: Tissue expanders and nipple skin-sparring mastectomies
Patient 18
Breast Reconstruction
This 55-year-old female from New Jersey underwent immediate breast reconstruction with Dr. Naveen Ahuja following a left mastectomy. After the tissue expansion was completed, a 300cc smooth round moderate plus silicone gel implant was placed in the subglandular position.
Procedures performed: Direct-To-Implant Breast Reconstruction
Patient 19
Breast Reconstruction
This 46-year-old presents to the office with a diagnosis of left breast cancer. She is also BRCA-positive and has a strong family history of breast cancer. Due to this, she has decided to pursue bilateral mastectomies with immediate reconstruction with Dr. Philip Wey. She proceeded to have placement of tissue expanders with the final step being placement of a bilateral 375cc silicone memory gel high profile implants. Her current bra size is 36D. Photos at one year.
Procedures performed: Tissue expanders and nipple skin-sparring mastectomies
Patient 20
Breast Reconstruction
This 30-year-old female from New Jersey was recently diagnosed as BRCA2 positive and has decided to pursue bilateral prophylactic mastectomies with immediate reconstruction. Dr. Wey performed bilateral mastectomies with placement of tissue expanders. The expanders were filled bi-weekly for two months. After expansion was complete, the second surgery consisted of placement of 590cc ultra high profile Mentor memory gel silicone implants. Her current bra size is 36D/DD. Photos at nine months.
Procedures performed: Bilateral mastectomies, Tissue expansion, Breast Implants
Patient 21
Breast Reconstruction
This is a 52 year-old, 5’3 150 lbs female who was recently diagnosed with left breast cancer and has a strong family history of breast cancer. She has decided to pursue bilateral mastectomies with immediate reconstruction. After the tissue expansion was completed, Mentor high projection memory gel 620cc silicone implants were placed. Photos at one year.
Procedures performed: Bilateral mastectomies, Tissue expansion, Breast Implants
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