Breast reconstruction

Your mastectomy should be coordinated with your reconstruction through your plastic surgeon. Do not  simply go to a genera surgeon to hae the mastectomy and then wait until after to seek a plastic surgeon to do the reconstruction.It needs to be coordinated. Often what a plastic surgeon can and needs to do will greatly influence your method of surgical treatment for the cancer itself. If you are going to have bilateral total mastectomies, it might be possible to spare both skin and nipple/areolar complex, This makes reconstruction infinitely more easy especially if you want relative small breasts in the end. I suspect that you will not need radiation if you choose to have total mastectomies so implant reconstruction is the simplest and more logical technique

I have had a lot of success with one step breast reconstruction, especially for small breasts. At the time of mastectomy, the plastic surgeon places the implant in a sub-pectoral postion. I personally use Alloderm, which is like a sheet of collagen,  to make an "internal bra" to hold the implant in just the right spot.