Breast Reconstruction

Expander/permanent implant in a patient

TRAM (abdominal) Flap

Expander/Permanent Implant with Opposite Breast Augmentation for Symmetry

A young woman who underwent a breast augmentation by a physician not certified by the American Board of Plastic Surgery. The patient was referred by her family practice physician the left implant exposed and protruding through the skin half way between the nipple and infrmammary fold with impending exposure of the right implant. Both implants were removed. She is shown on the left six months after implat removal. Bilateral permanent expanders were then placed under the muscle deep to the "breasts". What was left of the breasts was slowly expanded along with the underlying muscle. Several revisions were required for symmetry to obtain the foinal result shown on the right.

Patient who underwent a previous breast augmentation (see scar below mastectomy scar) reconstructed with expander/permanent implant

41 year old woman underwent circumareolar purse string closure bilateral mastectomies with expander placement at the time of mastectomy. She was serially expanded followed by expander removal and permanent implant placement with nipple areolar reconstruction using the scar and reconstructive tattooing.

Middle aged woman who had first generation silicone implants placed many years ago in front of the muscle. The implants ruptured and silicone migrated into the overlying breast tissue. The implants and all free silicone were removed. Three months later the breasts were reconstructed with bilateral TRAM flaps. The flap monitoring skin islands from the abdomen can be seen on the underside of each breast.