Nipple-Sparing Mastectomy with 2-Stage Implant Reconstruction and Fat Transfer

This 45-year-old woman was diagnosed with breast cancer and elected to undergo a nipple-sparing mastectomy using a concealed inframammary fold (IMF) incision to preserve a natural appearance. Her primary goal was not only to restore her breast shape but to look even better than before — with more volume, fullness, and a balanced silhouette.

Dr. Salvatore Pacella performed a 2-stage breast reconstruction:

• Stage 1: Placement of a tissue expander at the time of mastectomy to gradually create space and shape the pocket.
• Stage 2: Exchange for ultra-high profile silicone implants, combined with autologous fat transfer to the upper pole and cleavage zone for soft, natural contours.

At final follow-up, she has a beautiful, full result with preserved nipple position, improved volume, and enhanced projection. Her breasts look balanced, feminine, and natural—and most importantly, she feels empowered and confident.