Breast Reconstruction
Category: Breast Reconstruction (TRAM Flap)
Age: 67
Height: 5' 6"
Weight: 164 lbs
Description: This patient had undergone a previous right sided lumpectomy with radiation for breast cancer which left her as a 34C on the right side and 34D/DD on the left. 19 years later, she developed a lump in her right breast near the area of her prior lumpectomy. She then underwent a right sided mastectomy. After discussion of her breast reconstruction options with Dr. Lu, the patient elected to undergo a pedicled TRAM flap reconstruction. The patient had had a previous ruptured appendix, and the scar had to be taken into account during the careful preoperative planning. For improved symmetry, Dr. Lu performed a small lift of the left breast, as well as a nipple reconstruction of the right breast utilizing TRAM flap tissue and restoration of the right inframammary fold. The patient is pleased both with the feel and shape of her new breasts, improved symmetry, as well as a tighter, flatter abdomen.
Before Mastectomy
Before TRAM
Abdomen 4 weeks Postop TRAM
 12 weeks Postop TRAM
After raise Right Inframammary fold, Nipple Reconstruction, Tattoo and Left breast lift

Category: Breast Reconstruction (TRAM Flap)
Age: 66
Height: 5' 8"
Weight: 150 lbs
Description: This patient had undergone a left sided mastectomy 3 years previously for in situ breast cancer (DCIS). She desired reconstruction and was attracted to the idea of using her own abdominal tissue. After discussion of her breast reconstruction options with Dr. Lu, the patient elected to undergo a pedicled TRAM flap reconstruction. The patient had some hardened fat which was removed at a separate procedure. For improved symmetry, Dr. Lu performed a small lift of the left breast. The patient elected to have nipple areolar reconstruction with a three dimensional tattoo only and is pleased with her result.
Before
4 months Postop TRAM and 2 months postop right
breast lift and left removal of fat necrosis
2 weeks after nipple areolar 3D tattoo

Category: Breast Reconstruction (Lumpectomy and Simultaneous Breast Reduction)
Age: 49
Height: 5' 3"
Weight: 174 lbs
Description: This patient was diagnosed with invasive ductal (breast) cancer of her right upper outer breast. She was advised by her breast surgeon that approximately 10cm of tissue with skin would need to be removed. She also had very large 38E breasts and had considered breast reduction in the past but had never found a good time to pursue it. Dr. Lu discussed options of post mastectomy reconstruction versus a large lumpectomy with simultaneous breast reduction. (Lumpectomy without rearranging tissue would have left a significant depression and displaced her nipple areolar complex towards her upper outer breast.) The patient elected for lumpectomy and breast reduction, her tumor was completely removed and her skin was healed enough to allow her to start chemotherapy 6 weeks after surgery. 758 grams were removed from the right side and 667 grams from the left. She subsequently had radiation to the breast. She is very pleased with her result, particularly preservation of breast sensation, breast symmetry and size (38C/D), and the completion of surgery in one operating room visit.
Preop

Preoperative Markings

   

5 Months Postop


Category:  Breast Reconstruction (TRAM Flap)
Age: 55
Weight: 180 lbs
Height: 5'8"
Description:  This patient had undergone a right sided mastectomy for breast cancer.  Her case was complicated by radiation, failed prior attempt at breast reconstruction by another surgeon, and the loss of 120 pounds through diet and exercise.  After discussion of her breast reconstruction options with Dr. Lu, the patient elected to undergo a TRAM flap reconstruction.  She is pleased both with the feel and shape of her new breast, as well as the improvement in her abdominal contour. 

Before

Stage 1 - 10 weeks post right TRAM Flap

Stage 2 -  8 weeks post left mastopexy & augmentation

Stage 3 - 6 weeks post nipple reconstruction

Stage 4 - Day of areola tattoo and two weeks after


Category: Breast Reconstruction (Tissue Expander)
Age: 60
Weight: 176 lbs
Height: 5' 5"
Description: This patient was diagnosed with invasive ductal (breast) cancer of her left breast. She elected to have a skin and nipple sparing mastectomy (Photo 1). After her skin had healed, a tissue expander (balloon) was placed and inflated over a period of 5 weeks to stretch the skin (Photo 2). 5 months later, a 550cc saline implant was placed on the left, with adjustment of the fold under the implant, liposuction and a right sided breast lift/reduction (Photo 3 and 4). She is very pleased with her symmetry in and out of clothing.
After Mastectomy

After Tissue Expansion

After Implant and Reduction


Category: Breast Reconstruction (Tissue Expanders)
Age: 52
Weight: 198 lbs
Height: 5' 6"
Description: This patient started with underlying breast asymmetry (right breast larger than left Photo 1). She was diagnosed with invasive ductal (breast) cancer of her left breast. She elected to have a skin and nipple sparing mastectomy (Photo 2). After her skin had healed, a tissue expander (balloon) was placed and inflated over a period of 4 weeks to stretch the skin (Photo 3). 4 months later, a 750cc silicone implant was placed on the right, with a left sided breast lift/reduction (Photo 4 and 5). She is very pleased with her result.
Before Mastectomy
After Mastectomy

After Tissue Expansion

After Implant and Lift


Category: Breast Reconstruction (Tissue Expanders/Implants)
Age: 47
Weight: 137 lbs
Height: 5' 6"
Description: This patient had undergone testing and was diagnosed with a mutation in the breast cancer gene BRCA2. She elected to have bilateral nipple sparing mastectomies to reduce her future breast cancer risk. After her mastectomies, she came to see Dr. Lu for assistance with healing her nipple areolar complexes and to discuss breast reconstruction. After discussion of her options with Dr. Lu, the patient elected to undergo 2 stage expander (to stretch the skin) and silicone implant reconstruction. The patient is pleased both with the feel and shape of her new breasts, and was happy to keep her own nipple and areolar complexes.
After Mastectomy

After Tissue Expanders

After Implants


Category: Breast Reconstruction (Tissue Expanders)
Age: 44
Weight: 114 lbs
Height: 5' 2"
Description: This patient had a strong family history of breast cancer and subsequently tested positive for a BRCA1 (breast cancer susceptibility) gene mutation. Due to her high breast cancer risk, she elected to have bilateral prophylactic skin sparing (not nipple sparing) mastectomies. At the time of her mastectomies, bilateral tissue expanders were placed and inflated over a period of 2 months to stretch the skin. Four months after her mastectomies, bilateral 300cc high profile saline implants were placed. She subsequently had nipple reconstruction and tattooing of the areolas and is very pleased with her results.
Before Mastectomies

After Tissue Expanders

After implants and nipple reconstruction

Day of nipple tattoo (left) and two weeks after


Kimberly K. Lu - Issaquah Plastic Surgery - (425) 392-8282