Intra operative acellular dermis placement
Post fat grafting
The patient presented post mastectomies with thin coverage and a peak shaped chest. We discussed using latissimus flaps for improved coverage, but she wanted to avoid a more involved operation. We used acellular dermis with the initial expander and implant reconstruction to improve the tissue thickness inferiorly and to keep the implants from sliding off the chest and into the axillae (arm pits).
She then had visible rippling secondary to the thin coverage. This was improved with four sessions of fat grafting. Note the decreased rippling, improved superior and medial transition from breast mound to chest.