These patients have generously allowed us to share their photos with you.
We hope you enjoy this opportunity to see the many possibilities of plastic surgery.
IMAGINE YOURSELF AT PLASTIC SURGERY ARTS OF NJ BROWSE OUR BEFORE & AFTER BREAST GALLERY
BREAST RECONSTRUCTION (NIPPLE SPARING MASTECTOMY)
Patient 1 This is a 49 year old female diagnosed with right sided LCIS with a strong family history of breast cancer. She underwent a bilateral nipple sparing mastectomy with bilateral tissue expanders and 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. Dr. Nini. (KTN)
Procedures performed: Tissue Expansion, Implants
BREAST RECONSTRUCTION
Patient 2 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 (KTN)
Procedures performed: (link: /procedures/breast-surgery/breast-reconstruction/ text: Skin Envelope Reduction Mastectomy With Tissue Expander Based Reconstruction
BREAST RECONSTRUCTION (NIPPLE SPARING MASTECTOMY)
Patient 3 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. (PDW)
Procedures performed: Nipple Skin Sparing Mastectomies and Expander Based reconstruction
BREAST RECONSTRUCTION (NIPPLE SPARING MASTECTOMY)
Patient 4 This is a 30 year old female who presents in the office for 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. Dr. Nini. (KTN)
Procedures performed: Nipple Skin Sparing Mastectomies and Expander Based reconstruction
BREAST RECONSTRUCTION (NIPPLE SPARING MASTECTOMY)
Patient 5 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. After bilateral tissue expansion was complete, Mentor 550cc smooth round high profile silicone implants were placed sub muscularly. Photos taken at 10 months after implants were placed. Dr. Ahuja. (NKA)
Procedures performed: Nipple Sparing Mastectomies with Expander Based Reconstruction
BREAST RECONSTRUCTION (NIPPLE SPARING MASTECTOMY)
Patient 6 This patient had bilateral cosmetic submuscular breast implants placed previously years ago and now needs reconstruction after bilateral prophylactic mastectomy. She is 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! Dr. Wey. (PDW)
Procedures performed: Single stage Direct-to-Implant Breast Reconstruction
BREAST RECONSTRUCTION (NIPPLE SPARING MASTECTOMY)
Patient 7 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! Dr. Nini. (KTN)
Procedures performed: Prophylactic Nipple Skin Sparing Mastectomies and Expander Based reconstruction
BREAST RECONSTRUCTION (NIPPLE SPARING MASTECTOMY)
Patient 8 This is a 52-year-old woman who has decided to pursue bilateral prophylactic (preventative) mastectomy with immediate reconstruction due to a strong family history and a high risk of developing breast cancer. She was able to preserve her nipple and areola utilizing a nipple-sparing mastectomy technique. Immediate reconstruction was performed using tissue expanders and AlloDerm ADM for extra support. After the expansion was complete, Allergan Natrelle 550cc smooth round high profile implants were placed. We were able to achieve an enhanced volume with minimal scars. Photos obtained at 1 year. Dr. Wey. (PDW)
Procedures performed: Nipple Skin Sparing Mastectomy with Silicone Implants
BREAST RECONSTRUCTION (NIPPLE SPARING MASTECTOMY)
Patient 9 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. Dr. Nini. (KTN)
Procedures performed: Sub-pectoral breast reconstruction with anatomical implant
BREAST RECONSTRUCTION (NIPPLE SPARING MASTECTOMY)
Patient 10 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. Dr. Nini. (KTN)
Procedures performed: Nipple Skin Sparing Mastectomies, Anatomical Implants
BREAST RECONSTRUCTION (NIPPLE SPARING MASTECTOMY)
Patient 11 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. Dr. Nini. (KTN)
Procedures performed: Nipple skin sparing mastectomy with anatomic silicone breast implants
BREAST RECONSTRUCTION (MULTIPLE TECHNIQUES)
Patient 12 This is a 41-year-old woman who presents with left breast cancer and had decided to pursue bilateral mastectomies. We combined techniques to include nipple-sparing mastectomy on her right and traditional mastectomy on her left side. A latissimus flap on the left side only and bilateral tissue expander reconstruction was performed. Mentor 450cc smooth round high profile implants were then placed. To complete the reconstruction, left nipple reconstruction and areola tattooing was performed. Dr. Wey. (PDW)
Procedures performed: Latissimus Flap, Tissue Expansion, Implants, Nipple Reconstruction
BREAST RECONSTRUCTION (NIPPLE SPARING MASTECTOMY)
Patient 13 This 49-year-old woman was discovered to have DCIS in both breasts. She was given the choice of lumpectomy and radiation or bilateral mastectomy and reconstruction. She said she felt more comfortable with mastectomy and reconstruction because both breasts had demonstrated a tendency to turn cancerous. Because she demonstrated advanced grade 2 ptosis, or sagging, Dr. Nini recommended performing mastectomies through a breast lift, or mastopexy, incision. He also perfomed a new technique where her native nipples were immediately grafted onto the middle of the areola. The areolar skin was a portion of the latissimus dorsi flaps which were used to cover the expanders. The expanders were exchanged for a cohesive gel silicone implant which was followed by areolar tattooing to complete the reconstruction. Her photos were taken at the one-year anniversary of her first procedure. Dr. Nini. (KTN)
Procedures performed: Skin Sparing Mastectomy and Reconstruction using Mastopexy Technique, Immediate Nipple Reconstruction, Silicone Implants
BREAST RECONSTRUCTION (DELAYED RECONSTRUCTION)
Patient 14 This patient is a 48-year-old woman who presents for breast reconstruction one year after double mastectomy. She had substantial contour issues as well as significant skin loss. She underwent a staged reconstruction using her own body tissues to give her a more natural result. Bilateral latissimus dorsi flaps (from the back) along with insertion of tissue expanders was performed first. The expanders were then exchanged for Mentor 475-500 cc smooth, round, high-profile silicone gel implants. Nipple and areolar reconstruction and tattooing completed the reconstruction.
Photos at 1 year. Dr. Wey. (PDW)
Procedures performed: Latissimus Flaps, Tissue Expansion, Implants, Nipple Reconstruction
BREAST RECONSTRUCTION: LATISSIMUS DORSI, EXPANDERS AND SILICONE IMPLANTS
Patient 15 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. Dr. Nini. (KTN)
Procedures performed: Breast reconstruction with latissimus dorsi, expanders and silicone implants
BREAST RECONSTRUCTION (NIPPLE SPARING MASTECTOMY)
Patient 16 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. Dr. Wey. (PDW)
Procedures performed: Latissimus Flap, Tissue Expansion, Implants
BREAST LIFT (NIPPLE SPARING MASTECTOMIES)
Patient 17 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. Dr. Nini. (KTN)
Procedures performed: Nipple skin sparing mastectomy, anatomically-shaped silicone breast implants, autologous fat grafting
BREAST RECONSTRUCTION (MULTIPLE TECHNIQUES)
Patient 18 This is a 42-year-old woman who presents with left breast cancer. We were able to use many techniques to customize her treatment plan. A traditional mastectomy on the left with latissimus dorsi flap and tissue expander was performed. On the right side, nipple-sparing mastectomy and tissue expansion was performed. To complete the reconstruction, bilateral Mentor smooth round high profile silicone gel implants were placed submuscularly. She also had left nipple reconstruction and areola tattooing. Dr. Wey. (PDW)
Procedures performed: Latissimus Flap, Tissue Expansion, Implants, Nipple Reconstruction
BREAST RECONSTRUCTION (NIPPLE SPARING MASTECTOMY)
Patient 19 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. (NKA)
Procedures performed: Nipple Skin Sparing Mastectomies and Expander Based reconstruction
BREAST RECONSTRUCTION (NIPPLE SPARING MASTECTOMY)
Patient 20 This patient is a 46-year-old woman with a right breast cancer and a left breast papillomatosis. Bilateral mastectomy with removal of the nipple areola complexes was recommended by her oncologic surgeon. She was a B cup and had requested breast reconstruction to a larger breast size. Tissue expanders and ADM were placed at the time of mastectomy and filled to 700 cc. Three months later her reconstruction was completed by removing the tissue expanders and replacing them with a 750 cc High Profile silicone breast implant and inner liner of a cellular dermal matrix Flex HD and autologous fat transfer to the upper pole depressions which all too frequently result from aggressive mastectomies. Her postoperative photographs reveal a nice breast contour from the oblique view which looks even more attractive in a bra and clothing. Her breast size is now a full C, small D cup. Nipple reconstructions were carried out using skate flap
and tattoo pigmentation. Dr. Nini. (KTN)
Procedures performed: Tissue Expansion, Implants, Nipple Reconstruction
BREAST RECONSTRUCTION (TRADITIONAL MASTECTOMY)
Patient 21 This is a 42-year-old woman with an early right breast cancer. Because of a strong family history, she had sought bilateral mastectomy and reconstruction. The oncologic surgeon chose not to recommend nipple sparing mastectomy for this patient. Mastectomies were carried out through horizontal incisions removing the nipple areolar complexes and on the same day, tissue expanders and Flex HD acellular dermal matrix was placed. Her expanders were filled to 500 cc and four months later, the expanders were removed and replaced with a 550 cc smooth round High Profile silicone breast implant and an inner liner of ADM. Nipple reconstructions were carried out with skate flaps and tattooing. Her postoperative photos were taken 18 months after her first consultation. Dr. Nini. (KTN)
Procedures performed: Tissue Expansion, Implants, Nipple Reconstruction
BREAST RECONSTRUCTION (NIPPLE SPARING MASTECTOMY)
Patient 22 This patient is a 42-year-old woman diagnosed with multicentric left breast cancer. She was scheduled for bilateral mastectomies and desired immediate breast reconstruction. Bilateral nipple sparing mastectomy with immediate reconstruction with placement of tissue expanders was performed. Five months after completing tissue expansion, 500 cc Mentor high profile silicone implants were placed along with Flex Pliable ADM to enhance the upper breast. Photos taken 6 months after initial surgery. Dr. Nini. (KTN)
Procedures performed: Tissue Expanders, Implants
BREAST RECONSTRUCTION (REDUCTION PATTERN, IMMEDIATE NIPPLE GRAFTS)
Patient 23 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. Dr. Nini. (KTN)
Procedures performed: Expander Based Breast Reconstruction, silicone implants, nipple grafting
BREAST RECONSTRUCTION (NIPPLE SPARING MASTECTOMY)
Patient 24 This patient is a 41-year-old woman who had bilateral sub muscular breast implants placed years ago and now presented with a diagnosis of DCIS of the right breast. In light of her reconstructive options, she had decided to pursue bilateral nipple sparing mastectomy with immediate reconstruction with tissue expansion. After the expansion was complete, a 500cc Allergan Natrelle silicone gel implant was placed along with Alloderm ADM to enhance the upper breast. Photos taken at 1 year. Dr. Nini. (KTN)
Procedures performed: Tissue Expansion, Implants
BREAST RECONSTRUCTION (TRADITIONAL MASTECTOMY)
Patient 25 This is a 37-year-old woman with a diagnosis of extensive DCIS of the right breast. She underwent bilateral mastectomies with immediate reconstruction and placement of bilateral tissue expanders. After completing expansion, 650cc Allergan Natrelle silicone implants were placed. Bilateral nipple reconstruction and aerolar tattooing completed her reconstruction. Photos at 1 year. Dr. Nini. (KTN)
Procedures performed: Tissue Expansion, Implants, Nipple Reconstruction
BREAST RECONSTRUCTION (NIPPLE SPARING MASTECTOMY)
Patient 26 This is a 37 -year-old woman with DCIS in the right breast and a strong family history for breast cancer. A bilateral mastectomy was recommended to her and she was referred for breast reconstruction. Together with the breast surgeon, a nipple skin sparing mastectomy and immediate reconstruction with tissue expanders was performed. The second stage procedure performed 3 months later included replacement of the tissue expanders for silicone implants and a new technique where Dr. Nini places an inner liner of acellular dermal matrix to completely cover the breast implants. This dramatically reduces the risk of capsular contracture and breast implant distortion, as well as the rippling which is frequently seen with breast reconstruction. Her photographs are shown one year after completion of the reconstruction. Dr. Nini. (KTN)
Procedures performed: Expander Based Breast Reconstruction, silicone implants, nipple grafting
BREAST RECONSTRUCTION (TRADITIONAL MASTECTOMY WITH BREAST LIFT)
Patient 27 This is a 39-year-old woman who was diagnosed with right breast cancer and has decided to pursue bilateral mastectomy. We designed her mastectomy incision to include a breast lift to give her a more youthful appearance. Bilateral latissimus flap reconstruction (from the back) and insertion of tissue expanders was performed. A Mentor smooth round moderate plus profile 300cc silcone gel implant was used to complete the reconstruction as well as bilateral nipple reconstruction and areolar tattooing. Dr. Wey. (PDW)
Procedures performed: Latissimus Flaps, Tissue Expanders, Breast Lift, Implants, Nipple Reconstruction
BREAST RECONSTRUCTION
Patient 28 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. Dr. Nini. (KTN)
Procedures performed: Nipple Sparing Mastectomy with Implant Based Reconstruction, Stem Cell Transfer and Balancing Reduction
BREAST RECONSTRUCTION
Patient 29 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. (PDW)
BREAST RECONSTRUCTION
Patient 30 This is a 55 year old female who is interested in immediate breast reconstruction following left mastectomy. After the tissue expansion was completed, a 300cc smooth round moderate plus silicone gel implant was placed in the subglandular position. Photos at 7 months. (NKA)
BREAST RECONSTRUCTION
Patient 31 This 46 year-old who 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. 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. (PDW)
BREAST RECONSTRUCTION
Patient 32 This is a 30 year old female who was recently diagnosed as BRCA2 positive and has decided to pursue bilateral prophylactic mastectomies with immediate reconstruction. Her first surgery was mastectomies with placement of bilateral 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. Current bra size is 36D/DD. Photos at nine months. (PDW)
BREAST RECONSTRUCTION
Patient 33 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. (KTN)
BREAST RECONSTRUCTION
Patient 34 This is a 46 year old, 4’11, 125 lb female who was diagnosed with left breast DCIS. She wants the least invasive breast reconstruction possible. After consultation, we proceeded with bilateral tissue expander placement at the time of the mastectomy. After her tissue expansion process was completed, silicone memory gel 500cc high profile implants were used to complete the reconstruction. Photos at nine months. (PDW)
Procedures performed: Bilateral Breast Reconstruction
Imagine Yourself at PSANJ Today!
