Breast Reconstruction: Tissue Expander Based Reconstruction Michael J Bass, MD, JD Plastic Surgeon www.drmichaeljbass.com Michael J Bass Plastic Surgery, PLLC

Premastectomy Evaluation 40 year old female status post right breast lumpectomy for DCIS Tested BRCA-1 (+) Mother died at age 60 (ovarian CA) Status post pan hysterectomy 3/31/2010

Preoperative Counseling Patient counseled on implant based reconstruction versus autologous based reconstruction After weighing all the pros and cons of each, patient decides on implant based reconstruction

Immediate Reconstruction at Time of Bilateral Mastectomies with Tissue Expanders and Acellular Dermal Matrix 4/15/2010

Maximal Expansion to 800 cc’s 6/1/2010

Post TE Removal, Permanent Implant Placement 700 cc’s 7/21/2010 Original mastectomy scar used every time for reentry to breast pockets; no new incisions used

Left Capsulotomy, IMF Lowering 10/25/2011

Right Capsulotomy 1/21/2011

Bilateral Nipple Reconstruction: Modified Skate Flaps 3/10/2011 Foam protectors around reconstructed nipples

Bilateral Areolar Tattooing 11/15/2011

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

Michael J Bass, MD, JD Plastic Surgeon www.drmichaeljbass.com