Severe influence of early pregnancy on newly reconstructed breast

Since mastectomy may have a devastative effect on the patient's appearance, body image and psychology, especially in young women, immediate breast reconstruction is widely preferred to avoid the unpleasant results caused by the defect of mastectomy. Presented here is the case of a 33-year-old patient. Considering her fibrocystic mastopathy, atypical ductal hyperplasia and a history of familial breast cancer, subcutaneous mastectomy and breast reconstruction using an implant was planned with skin reduction and repositioning of the areola-nipple complex. During her postoperative follow-up examinations which were conducted periodically, it was expected that the formation of the breasts in relation to the prosthesis would take place in the healing time. In contrast, an increase in the skin thickness and breast fullness, massive filling in the submammary fold, a vertical suture depression and consolidation were observed. These unexpected deformities were based on a pregnancy beginning just after the last operation. Later, the breast findings were followed both clinically and photographically. After termination of the pregnancy, reduction in the skin thickness, involution of the glandular tissue and changes in the shape of the breasts were observed to continue for 6 months. The end result was the development of an unacceptable breast appearance which required a major revisional surgery. Early pregnancy after subcutaneous mastectomy with reconstruction severely affects development leading to distortions in the shape of the breast during pregnancy. Additionally, involution after delivery is not also good enough to provide acceptable outcomes.