Nipple Sparing Reconstruction

This patient had moderate preoperative breast asymmetries with very tight nipple to fold distance on her right breast. She developed right breast cancer and underwent bilateral nipple sparing mastectomies through wavy incisions just lateral to her nipples. She had immediate subpectoral (below the muscle) reconstruction with tissue expanders and alloderm. She progressed through expansion while undergoing chemotherapy. She then completed a course of radiation therapy to the right breast. Six months later she showed signs of significant contracture and skin tightness from radiation. Dr. Geiger exchanged her expanders at that time for the latest generation, highly cohesive (gummy bear) smooth round silicone implants while recruiting additional tissue from her upper abdomen (a “Ryan Flap” procedure) to add more skin between her nipple and breast fold. Overall she has very nice result with improved cleavage and a fuller appearance as desired.