WHAT'S NEW

The patient is a slender woman with minimal redundant chest skin and poor skeletal and inframammary fold support for a breast implant.  She requests a high profile silicone gel implant for maximal size on her narrow diameter chest.  A textured implant is chosen to minimize device movement and the inframammary fold is reinforced at surgery with deeply placed, long lasting absorbable sutures.  Post operatively, she has appropriate stretch of the nipple to fold distance and maintains a well defined inframammary fold for an aesthetic result.

Pre op anterior view

Post op anterior view

Pre op oblique view

Post op oblique view

The patient is a woman with a mastectomy on the left and ptotic (droopy) breast on the right who presents for a Trans Rectus Abdominus Muscle Flap and Mastopexy (breast lift).  The ultimate goal is symmetry in the setting of a native breast on one side and mastectomy flaps on the other.  The TRAM, while a large operation, supplies natural feeling fat from the abdomen to the breast location and gives a permanent result without the potential downsides of an implant.  Not all patients are candidates, nor do all want the additional risks associated with a TRAM.

The patient had a large weight loss with extra skin at her abdomen, flanks, and back.  She had a previous full abdominoplasty by another surgeon, but was dissatisfied with fullness in her mons.  Her mons, lower abdomen, flanks, and back were improved with a body lift.  The standard circumferential incision is lower, near the buttocks.  In this patient’s case, the incision was raised to remove the maximal amount of tissue.

Anterior Pre op

Anterior Post op

Posterior Pre op

Posterior Post op

The patient is a woman who had bilateral breast augmentation when she was diagnosed with breast cancer on the left.  She had lumpectomy and radiation on the left with the pre op result as shown.  Contracture of breast implants after radiation therapy is a common occurrence.  She had revision with latissimus flap and fat grafting on the left and capsulectomy and implant exchange on both sides.

pre op

post op

pre op

post op

The patient had previous expander and saline implant reconstruction by another surgeon.  She presented with right implant deflation and dissatisfaction with her tattooed nipple reconstruction.  She had revision with re-expansion of the right chest, placement of new silicone implants on both sides, and nipple areolar reconstruction with local flap formation and skin grafts from the groin.

Right saline implant deflation

Post implant replacement and nipple reconstruction revision