BRCA Positive in The Woodlands, TX with Nipple-Sparing Subpectoral Implant Recon

This is a delightful mother of two in her 30's with a known inherited BRCA gene mutation putting her at high lifetime risk to develop breast cancer. She decided to undergo prophylactic nipple-sparing mastectomies for risk reduction. She desired implant-based reconstruction with a goal of increasing her breast size. To accomplish this, a two-stage approach with initial placement of tissue expanders was recommended. Her nipple-sparing mastectomies were performed through incisions under each breast. The first stage of reconstruction was placement of tissue expanders and FlexHD acellular dermal matrix. As the patient was very thin, it was necessary to perform her reconstruction in a subpectoral pocket under the pectoralis major muscle. Gentle, gradual pocket expansion was performed at a series of clinic visits. The second surgery occurred 3 months later, replacing the tissue expanders with 370 cc Mentor MemoryGel moderate plus profile Xtra, smooth, round silicone gel implants.  Autologous fat grafting was also utilized to deliver a smooth natural upper pole slope.