This patient was a 51 year-old female who presented to the office with right sided breast cancer. She opted for bilateral mastectomies. We discussed her options for breast reconstruction and decided on a single stage breast reconstruction with 500 ccs Anatomical Cohesive Gel implants placed in the subglandular position. The patient had her bilateral mastectomies via the preferred vertical scar pattern to allow for a lift of the breasts with the reconstruction. The soft tissue envelopes were evaluated with the PDE-NEO tissue perfusion assessment device to ensure a viable soft tissue envelope before placement of the implants. The mastectomy flaps were viable. A 500 ccs cohesive gel shaped implant was wrapped with a large piece of Alloderm and placed into the pocket in the subcutaneous position. The subcutaneous position of the implant allows for less postoperative pain because it is above the muscle. No postoperative expansion is needed with the single stage reconstruction. Exparel was used for postoperative pain control. The patient wakes up from anesthesia with a fully formed breast mound. The patient had an uneventful postoperative course. She decided not to have nipple areola reconstruction at this time but knows that nipple reconstruction and areolar tattooing is an option for the future.
