PMC4801102_01
A, View of her left breast after 4 ineffective breast reconstruction attempts. There was no subcutaneous tissue in the left breast topography; the skin was fibrotic, hyperchromic, unexpansible, and tethered to the costal bone. At the site where the fourth costal cartilage was removed to access the recipient vessels for the microsurgical anastomosis, the skin was tethered to the pleura and her respiratory movements were easily noticed. B, View of her left breast at 3 years of breast lipofilling and 2 years of breast implant inclusion.
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At the site where the fourth costal cartilage was removed to access the recipient vessels for the microsurgical anastomosis, the skin was tethered to the pleura and her respiratory movements were easily noticed (Fig. 1A and see Fig., Supplementary Digital Content 1, which displays a flowchart overview of the case report, http://links.lww.com/PRSGO/A162). Six months after conclusion of lipofilling, complete remission of skin radiation sequelae was observed and the skin was soft and elastic again (see Fig., Supplementary Digital Content 1, which displays a flowchart overview of the case report, http://links.lww.com/PRSGO/A162) and with a minimum subcutaneous thickness of 2 cm at whole left breast topography (confirmed by ultrasonographyc and magnetic resonance imaging controls; see video, Supplementary Digital Content 3, which shows a complete remission of skin radiation sequelae. One year after this procedure, neither any absorption nor any sliding of the grafted fat over the implant toward the lower pole of the breast happened (Fig. 1B and see Fig.,
PMC4801102_02
See video, Supplementary Digital Content 3, which shows a complete remission of skin radiation sequelae. The skin is soft and elastic again at 3 years of breast lipofilling and 2 years of breast implant inclusion. http://links.lww.com/PRSGO/A164.
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Clinical, mammographic, ultrasonographic, and magnetic resonance imaging controls have not shown any evidence of breast cancer relapse after 8 years of mastectomy and 3 years of lipofilling (Fig. 2). Curiously, trying to justify why she does not want to undergo an additional procedure to aesthetically improve her reconstructed breast, she sent me some pictures of her breast, showing how she and her boyfriend see her breasts while she is standing (left) and lying (see Fig., Supplementary Digital Content 2, an image sent from the patient displaying her reconstructed breast.