This delightful woman in her 40's underwent genetic testing due to a strong family history of breast cancer in several family members. She was diagnosed with a genetic mutation that carried an increased lifetime risk of developing breast cancer. She saw a breast surgical oncologist who offered her risk reductive surgery with bilateral prophylactic mastectomies, and the patient was referred to Dr. Albright for breast reconstruction. The patient decided to save her nipples with nipple-sparing mastectomies. Given her thin body type and desire to be reconstructed with larger breast size, Dr. Albright felt that implant-based reconstruction would deliver the best breast reconstruction outcome in her case. Dr. Albright recommended a two-stage approach with initial prepectoral tissue expander placement for skin expansion to achieve a larger final breast volume. This approach also increased patient safety by minimizing the risk of inadequate blood flow to the nipple that could lead to tissue loss. Mentor CPX4 smooth expanders and AlloDerm acellular dermal matrix were used for a prepectoral technique. Four months later the patient had her tissue expanders replaced with 345 cc full projection Allergan Natrelle Inspira SoftTouch smooth silicone gel implants. Autologous fat grafting was also performed to further enhance and deliver a natural rounded breast shape. Her photos demonstrate her final breast reconstruction outcome after only 2 surgeries.
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