Before & After Gallery
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Before and After Gallery - Breast asymmetries and malformations


Patient 1.   Previous history, anatomy: 28 years old woman with a Poland syndrome (the congenital deficiency of the glandular tissue of the breast and the major pectoral muscle, aborted areola) on the right side, a deformed left breast as a consequence of extensive scarring after the removal of a congenital malignant tumor spreading inside the chest into the spinal canal at infancy, furthermore severe chest asymmetry and scoliosis.
       
Patient's wish:
create a right breast and acceptable symmetry.

We achieved this with careful planning of a 4 operation series during 1.5 years (please see below).
       
       
1st operation: breaking up the scar retracting the left breast with local flaps.

2nd operation: through only a few centimeter long hidden incisions on the back and in the armpit, the endoscopic transposition of the right latissimus muscle through the armpit to substitute the missing pectoral muscle, its fixation to the ribs, and simultaneously placing a postoperatively adjustable volume expander implant (Mentor, Becker 25) under the transposed muscle.

3rd operation: with endoscopic method, through a hidden incision in the left armpit, similarly as on the right side, the placement of a postoperatively adjustable volume expander implant (Mentor, Becker 25) with a narrower base under the pectoral muscle.

After filling the expanders in several steps, we increased the final volume of the right expander implant to 280 ml, and of the left one to 140 ml.

4th operation: removal of the remote injection domes of the expanders and lipofilling of the depression under the right collar-bone with fat harvested of the patient's abdomen.





Patient 2.   Anatomy: 36 years old male patient with a Poland syndrome (the congenital deficiency of the glandular tissue of the breast and the major pectoral muscle) on the right side and gynecomastia (abnormal development of large mammary glands in males) on the left side. Heavy smoker - that is a predisposition to bad scarring.  Patient's wish: correction of the very disturbing asymmetry of the breasts.  Procedure: through only a few centimeter long incisions on the back (under the shoulder-blade) and in the armpit on the right side, endoscopic transposition of the right latissimus muscle to replace the missing pectoral muscle, and through hidden incisions on the edge of the left areola and in the left armpit, endoscopic removal of the glandular tissue of the left breast with supplementary power assisted liposuction along the margins - all in a single operation.
       

  The postop photos are only 3 weeks old, small hematomas, swellings and fresh scars still can bee seen.





Patient 3.   Anatomy: pectoral muscles stronger than average, nipples-areolas in different heights, asymmetry in the fullness of the breasts preop.  Patient's wish: bulging on top, barely exceeding the contour of the chest wall on the side.
       
Implant: Mentor, textured, cohesive silicone gel-filled, round, moderate profile, 300 ml
Pocket: partially submuscular
Procedure: transaxillary, endoscopic
Cup: preop A, postop B-C
Age: 19
Children: 0
Postop photos are
6 months old.
Photos 9 years after the operation





Patient 4.   Anatomy: spinal distortion, asymmetries of the chest wall and of the arch of the ribs, slightly drooping breasts looking asymmetrically outwards preop.  Patient's wish: straight (not bulging)  contour on top, exceeding the chest wall on the side, the patient didn't want any kind of mastopexy.
       
Implant: Mentor, textured, cohesive silicone gel-filled, round, moderate plus profile, 275 ml
Pocket:  subglandular
Procedure: transaxillary, endoscopic
Cup: preop B, postop C
Age: 27
Children: 0
Postop photos are
2 months old, fresh scars.
Photos 5 years after the operation





Patient 5.   Anatomy: severe scoliosis, malformation of the chest and the arch of the ribs, multiple chest wall and breast asymmetries, bumps on the ribs, strong pectoral muscles, breasts and nipples-areolas asymmetrically looking outwards preop.  Patient's wish: a breast size and form exceeding the contour of the chest wall on the sides.
       
Implant: Mentor, textured, cohesive silicone gel-filled, round, moderate plus profile, 325 ml
Pocket: subfascial
Procedure: transaxillary, endoscopic
Cup: preop A, postop C
Age: 27
Children: 0
Postop photos are
3 months old, fresh scars.





Patient 6.   Anatomy: slightly tubular, asymmetrically drooping breasts, pectoral muscles much thicker than the average, moderate chest asymmetry.  Patient's wish: breasts bulging moderately on the top, full-round breast shape exceeding slightly the contour of the chest wall on the sides and breasts closer to each other, without reduction of the size of the areolas.  Procedure: endoscopic transaxillary breast augmentation + mastopexy with periareolar scars.
       
Implants: Mentor, textured, cohesive gel filled, round, moderate profile,
325 ml.
Pocket: subfascial
Cup: preop B,
postop D
Age: 34
Child and breast feeding before.
Postop photos are 2 months old, fresh scars before fading.






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