Figure 3.

Unilateral first-stage BR using TEs with PMRT. Patient images capture signs of progressive capsular formation over time, showing preoperative condition (A,E,I), follow-up at 1 months (B,F,J), at 6 months (±1 month; C,G,K) and at 1 year (±2 months; D,H,K). Row 1 shows a patient following NSM of the left breast and contralateral mastopexy and subpectoral implantation of a nanotextured TE. A progressive cranialization of the TE associated with non-painful, yet visible capsular contraction (grade III). Row 2 shows a patient following SSM of the left breast with horizontal access and subpectoral implantation of a microtextured TE and an absorbable mesh between the lower boarder of the pectoral muscle and the inframammary fold. This patient demonstrates a progressive thinning of the skin and cranialization of the TE, as well as painful symptomatic capsular contracture (grade IV). Row 3 shows a patient following bilateral SRM and pedicled nipple–areolar complexes’ implantation of a macrotextured TE and an absorbable mesh between the lower boarder of the pectoral muscle and the inframammary fold demonstrating progressive thinning of the skin and shrinkage of the soft-tissues on the left (K,L), as well as cranialization of the expander developing asymptomatic capsular contraction on the right (grade II) and painful contracture on the left (K,L: grade IV). BR: Breast reconstruction; NSM: nipple-sparing mastectomy; SRM: skin-reducing mastectomy; SSM: skin-sparing mastectomy; PMRT: post-mastectomy radiation therapy.