Skin-reducing mastectomy and prepectoral reconstruction in patients with BRCA mutation

This 43-year-old woman is a BRCA1 mutation carrier. She performed a lumpectomy, axillary lymphadenectomy and irradiation of the right breast for a right breast cancer 9 years ago. Currently, she is requesting a bilateral risk-reducing mastectomy. A bilateral skin and nipple preserving mastectomy was planned, in the right breast through an incision in the inframammary fold, and in the left breast using a vertical pattern. Breast reconstruction was carried out by means of the prepectoral placement of an implant covered with biological mesh
The prepectoral reconstruction allowed to maintain a mammary voluemn similar to the initial one. The right breast, irradiated 9 years earlier, showed greater edema during the postoperative period but without signs of mastitis. The vertical pattern of the left breast allowed the preservation of the NAC and most of the skin.
There is an asymmetry due to greater edema of the right breast as a consequence of radiotherapy
This video illustrates the skin and nipple preserving mastectomy through a vertical pattern.