This 42-year-old woman had a advanced right breast cancer and underwent a modified radical mastectomy. After undergoing chemotherapy, she decided upon a prophylactic left mastectomy with immediate reconstruction as well as a delayed reconstruction on the right breast. Her breast surgeon had used a non-skin sparing mastectomy technique which is rarely used today unless skin involvement or tumor size warrants this type of larger incision.
She had placement of tissue expanders with allograft with subsequent postoperative expansions in the office. Ultimately her expanders were exchanged to 500 cc smooth wall gel prostheses. She went on to nipple reconstruction with nipple areola tattooing. Despite the long scar she has had a very reasonable outcome with good symmetry and actually larger breast size as was her request.
Delayed reconstruction Is much more difficult and not performed As often as in the past since immediate breast reconstruction is favored in most cases. Indications to undergo radiation after mastectomy, autogenous reconstruction with flaps is favored.