Due to a strong family history of breast cancer, this nice mother of 2 underwent genetic testing which found a mutation associated with increased breast cancer risk. She decided to have risk-reducing prophylactic skin-sparing mastectomies. The patient looked at reconstruction as an opportunity to decrease the size of her large, heavy breasts. She reported wearing a 34 E cup bra, noting that her left breast was larger than the right. Her goal was to decrease breast size to a C cup. At the time of her mastectomy, a modified Wise pattern technique was used to reduce the breast skin surface area. Tissue expanders were placed for the first stage of reconstruction. The second stage included replacing the tissue expanders with 560 cc Allergan Natrelle Inspira Cohesive extra-full projection smooth round silicone gel implants. Fat grafting and insertion of GalaForm 3D mesh for tissue support were also performed in this stage. One additional outpatient procedure allowed additional fat grafting and nipple mound reconstruction. In-office nipple areola tattooing completed her reconstructive journey.
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