Revision of Reconstructed Breasts

50-year-old female with a history of breast DCIS. At the time of her consultation, she had already completed her bilateral mastectomy and reconstruction with breast implants. Patient was referred to our care from her surgical oncologist. Patient originally had bilateral nipple sparing mastectomies. She had multiple complications post operatively with an implant infection and has had multiple implant exchanges. Her last reconstruction revision surgery was 3 years ago with breast implant exchange and fat transfer. At the time of her consultation with Dr. Koch, she had pain in her left breast, especially on the lateral aspect. She also felt significant bilateral tightness sensations and let us know that she was very uncomfortable. Prior to her revision reconstruction surgery with Dr. Koch, she had 500cc breast implants. During her consultation she reviewed that she was okay with keeping the same size breasts but willing to change the size if it meant being more comfortable. At the time of consult, we discussed that there were four things that we needed to correct: 1. Volume: the implants are bottoming out as they are too large for her body and pocket. 2. Surface area: too large. needs to tighten. 3. Nipple position: left breast especially is malpositioned. 4. Animation: implants are submuscular, we recommend we change to above the muscle. The after pictures taken show her result at just 5 months following surgery. Implants placed: Allergan Natrelle Soft Touch 385cc. More

50-year-old female with a history of breast DCIS. At the time of her consultation, she had already completed her bilateral mastectomy and reconstruction with breast implants. Patient was referred to our care from her surgical oncologist. Patient originally had bilateral nipple sparing mastectomies. She had multiple complications post operatively with an implant infection and has had multiple implant exchanges. Her last reconstruction revision surgery was 3 years ago with breast implant exchange and fat transfer. At the time of her consultation with Dr. Koch, she had pain in her left breast, especially on the lateral aspect. She also felt significant bilateral tightness sensations and let us know that she was very uncomfortable. Prior to her revision reconstruction surgery with Dr. Koch, she had 500cc breast implants. During her consultation she reviewed that she was okay with keeping the same size breasts but willing to change the size if it meant being more comfortable. At the time of consult, we discussed that there were four things that we needed to correct: 1. Volume: the implants are bottoming out as they are too large for her body and pocket. 2. Surface area: too large. needs to tighten. 3. Nipple position: left breast especially is malpositioned. 4. Animation: implants are submuscular, we recommend we change to above the muscle. The after pictures taken show her result at just 5 months following surgery. Implants placed: Allergan Natrelle Soft Touch 385cc. More

50-year-old female with a history of breast DCIS. At the time of her consultation, she had already completed her bilateral mastectomy and reconstruction with breast implants. Patient was referred to our care from her surgical oncologist. Patient originally had bilateral nipple sparing mastectomies. She had multiple complications post operatively with an implant infection and has had multiple implant exchanges. Her last reconstruction revision surgery was 3 years ago with breast implant exchange and fat transfer. At the time of her consultation with Dr. Koch, she had pain in her left breast, especially on the lateral aspect. She also felt significant bilateral tightness sensations and let us know that she was very uncomfortable. Prior to her revision reconstruction surgery with Dr. Koch, she had 500cc breast implants. During her consultation she reviewed that she was okay with keeping the same size breasts but willing to change the size if it meant being more comfortable. At the time of consult, we discussed that there were four things that we needed to correct: 1. Volume: the implants are bottoming out as they are too large for her body and pocket. 2. Surface area: too large. needs to tighten. 3. Nipple position: left breast especially is malpositioned. 4. Animation: implants are submuscular, we recommend we change to above the muscle. The after pictures taken show her result at just 5 months following surgery. Implants placed: Allergan Natrelle Soft Touch 385cc. More