Figure 1. A:
Reconstruction of left breast with expander and asymmetry arising from contralateral breast ptosis; B:
Recurrence of breast asymmetry at 9 months after mastopexy with subglandular implant.
Figure 2. A:
Preoperative aspect of patient with left breast cancer associated with grade III ptosis; B:
At 6 months after breast reconstruction with a
submuscular expander and Pitanguy-type marking for correction of excess skin; C:
At three months after mammoplasty with submuscular implant.
Schematic drawing of the partial submuscular implant with coverage in the lower pole by preservation of the fat pad (B) and section of the connection
of the pectoral muscle (C) to the rectus abdominis fascia (A), thus achieving a better implant position in relation to the mammary groove.
Figure 4. A:
Preparation of the submuscular pocket via mammoplasty with disinsertion of muscle fibers in the inferomedial portion; B:
Implant positioned with partial closing of muscle fibers and preservation of the fat pad in the lower pole for coverage of the implant.
Figure 5. A:
Preoperative aspect of left breast cancer; B:
Seven months after left breast reconstruction with submuscular expander; C:
Three months after postoperative exchange of expander with a prosthesis and symmetrization with submuscular implant.Figure 6. A:
Preoperative right breast cancer; B:
5 months after right breast reconstruction with submuscular expander after mastectomy, with preservation of the nipple areola complex (NAC); C:
3 months after expander replacement with a prosthesis, in addition to mastopexy and contralateral breast symmetrization with submuscular implant.Figure 7. A:
Postoperative reconstruction of right breast with submuscular expander, followed by adjuvant radiotherapy; B:
5 months after expander replacement with a prosthesis associated with fat grafting and contralateral breast symmetrization with submuscular implant; C:
11 months after new fat grafting in the right breast and reconstruction of the nipple-areola complex without evidence of ptosis in the symmetrized breast.Figure 8. A:
Postoperative appearance of right breast reconstruction with submuscular expander; B:
10 months after expander exchange with a prosthesis, combined with fat grafting and contralateral breast symmetrization with a submuscular implant, and a third operation 3 months later for right nipple-areola complex reconstruction.Figure 9.
Distribution of patients and comorbidities, with 13 patients having one or more comorbidities and only 5 patients without other diseases.
Figure 11. A:
Preoperative appearance of patient with left breast cancer associated with grade III ptosis; B:
12 months after surgery with pseudoptosis of symmetrized right breast with submuscular prosthesis and expander replacement with a prosthesis in left breast reconstruction; C:
Three months after new right mastopexy with maintenance of implant position and reconstruction of the left nipple-areola complex.Figure 12. A:
Postoperative appearance of left breast reconstruction with submuscular expander followed by adjuvant radiotherapy; B:
3 months after expander exchange with a prosthesis combined with fat grafting and right breast symmetrization with submuscular prosthesis, complicated by partial necrosis of right nipple-areola complex, and resolution by second intention healing.