I've been diagnosed with multifocal, high grade DCIS which requires a mastectomy. I have always been very busty (34DD at age 15 and 34F now). Is it possible to be a D cup after breast reconstruction with expanders?
D Cup Possible After Breast Reconstruction with Expanders?
Doctor Answers 10
Yes it is possible.
Given that you already have 34F breasts, it will be possible to have D cup size breasts after reconstruction. You will have enough skin to drape over the tissue expander/implant. Also, your chest circumference (34) is not too large. A 500-600cc implant may give you 34D breast. Silicone implants come as large as 800cc; saline implants can be larger. However, silicone implants do feel more natural and softer than saline implants. For reconstructive patients who have thin mastectomy skin following mastectomy, I usually recommand using silicone implants. The beauty of implant-based reconstruction is that as you go through the expansion process, you can see how big/small you want to go for implant.
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What size can be achieved with implant reconstruction
The answer to your question depends on your anatomy. In addition, there is a limitation with respect to the projection you can achieve with the FDA approved Silicone Gel Implants. Additional projection can be achieved with a saline implant, but there will definitely be more rippling through your thin mastectomy skin. Remember, this is reconstruction and your PS will do his/her best to try to meet your goals. But there are definitely limitations of what can be achieved.
Size in breast reconstruction
Going large with an implant breast reconstruction increases the risks so I would advise a reduction on your opposite side and a more conservative implant reconstruction to match. Of course, in the end it's your choice but the complications are less if you stay a bit smaller.
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You can be a D cup after breast recostruction.
1) It is easier to create a smaller breast. So you can certainly be a D cup after breast reconstruction.
2) If you are having one mastectomy, then of course you will need a breast reduction on the other side.
Breast Reconstruction with Tissue Expanders
It is most likely possible to achieve what you desire as it sounds like you have a lot of skin to work with. It is also very important whom does you mastectomy and how it is done. So dont take the mastectomy part for granted.
Tissue expander reconstruction is a common type of breast reconstruction, one that I do a lot of, but it is not without risks. So you must be aware and take caution.
D cup after breast reconstruction
Getting to adesired volume in a "D" cup range is certainly possible when performing a breast reconstruction with tissue exapnders and implants. You should discuss this concern with your surgeon.
Symmetry is essential for a good result
It's possible to achieve a very large cup size with breast tissue expanders, but the largest possible size varies from patient-to-patient. The need for postoperative radiation, the thickness of the breast skin after mastectomy, and the total amount of skin removed all contribute to the final volume that can be achieved. Sometimes, additional skin and soft tissue (i.e a flap) will be added to the implant to add volume.
Even if you can achieve a size match with the contralateral breast, symmetry between a breast reconstructed with an implant and a natural breast is very difficult to achieve without either a breast lift or a breast reduction on the side without cancer. All natural breasts, particularly large ones, develop a certain degree of ptosis (droop) over time; breasts reconstructed with implants don't droop. Without a procedure to raise the breast, symmetry won't really be achieved.
Hope this helps. All the best.
Reconstructive Breast Size
The beauty of breast reconstruction with expanders is that you can continue to add fluid to the expander to stretch out the skin and get to the size that you are happy with. The problem that you may encounter is that the final implant may not be big enough. The implants are only up to about 800 cc and depending upon how big your breast is that may not be big enough.
When the mastectomy is performed it would be a good idea to have them weigh the specimen to get a rough idea of the dinal implant size that might be needed. I don't think that custome made implants are available in the US now. Your plastic surgeon may need to do some creative things to achieve the size you want.
Symmetry is essential to feel normal
It is possible to get to a D size with tissue expansion breast reconstruction. The question is what size do want the other side to be and what techniques will it take to make both sides as equal as possible. Make sure to have this discussion with a plastic surgeon prior to any breast surgery. The plastic surgeon and the oncologic surgeon should work together for you to get the best result possible.
Hopefully, you have been informed on all of the breast reconstruction options. Depending on your situation you may have other alternatives. The tissue expander reconstruction option is a common form of breast reconstruction and works well for many women. Obtaining a balance and symmetry of size is generally the first priority. This will allow you to feel comfortable with regular clothing styles.
Breast recosntruction with a large implant
Although this is possible, it really depends on the extent of the skin sparing mastectomy and adequacy of soft tissue coverage over the implant. Achieving a D cup may require a larger final implant that will likely be associated with a higher rate of complications. In this instance you may want to consider the autogenous tissue reconstruction or you may (not YOUR first choice) want to contemplate a reduction on the opposite side to diminish the size of your implant on the reconstructed side.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.