Breast Breast Reconstruction:Reconstruction:

Tissue Expander Tissue Expander

Based ReconstructionBased Reconstruction

Michael J Bass, MD, JDMichael J Bass, MD, JD

Plastic SurgeonPlastic Surgeon

www.drmichaeljbass.comwww.drmichaeljbass.com

Michael J Bass Plastic Surgery, Michael J Bass Plastic Surgery, PLLCPLLC

Premastectomy EvaluationPremastectomy Evaluation

► 40 year old female 40 year old female status post right status post right breast lumpectomy breast lumpectomy for DCISfor DCIS

► Tested BRCA-1 (+)Tested BRCA-1 (+)►Mother died at age Mother died at age

60 (ovarian CA)60 (ovarian CA)► Status post pan Status post pan

hysterectomyhysterectomy

3/31/2010

Preoperative CounselingPreoperative Counseling

►Patient counseled Patient counseled on implant based on implant based reconstruction reconstruction versus versus autologous based autologous based reconstructionreconstruction

►After weighing all After weighing all the pros and cons the pros and cons of each, patient of each, patient decides on decides on implant based implant based reconstructionreconstruction

Immediate Reconstruction at Immediate Reconstruction at Time of Bilateral Mastectomies Time of Bilateral Mastectomies

with Tissue Expanders and with Tissue Expanders and Acellular Dermal MatrixAcellular Dermal Matrix

4/15/2010

Maximal Expansion to 800 Maximal Expansion to 800 cccc’’ss

6/1/2010

Post TE Removal, Permanent Post TE Removal, Permanent Implant Placement 700 ccImplant Placement 700 cc’’ss

7/21/2010

Original mastectomy scar used every time for reentry to breast pockets; no new incisions used

Left Capsulotomy, IMF Left Capsulotomy, IMF LoweringLowering

10/25/2011

Right CapsulotomyRight Capsulotomy

1/21/2011

Bilateral Nipple Reconstruction: Bilateral Nipple Reconstruction: Modified Skate FlapsModified Skate Flaps

3/10/2011

Foam protectors around reconstructed nipples

Bilateral Areolar TattooingBilateral Areolar Tattooing

11/15/2011

Pre and Post ReconstructionPre and Post Reconstruction

3/31/2010 – 12/9/2011: 20 months (618 days), 6 surgeries

Michael J Bass, MD, Michael J Bass, MD, JDJD

Plastic SurgeonPlastic Surgeon

www.drmichaeljbass.comwww.drmichaeljbass.com