Implants vs. Tissue for Breast Recontruction After Prophylactic Mastectomy

I am a 36 yo thin, healthy, small breasted, BRCA1+ woman. I am planning a prophylactic nipple sparing double mastectomy. Because I am healthy, my surgeons say that the choice is mine -- either option (implant or tissue) will work well for me. I am wondering which reconstruction option will offer a more natural look and feel for small breasts?

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8 Doctor Answers | Asked by JCG in Westport, CT

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Implants are best for breast reconstruction in thin women.

Hi. Breast reconstruction with your own tissues is a very very big operation, which we reserve for ideal candidates only (women who need a tummy tuck anyway). Otherwise, you create a deformity with long scar in the abdomen. For most women, implant reconstruction is safer and much easier on you and the results with well done surgery are very good. This is our experience with several hundred patients.

Implants versus DIEP or TRAM for breast reconstruction

Dear JCG - your question is probably one of the most asked and encountered by thin women seeking breast reconstruction. In general, a reconstruction with your own tissue will be more natural and once it takes, the chances of problems are pretty much zero. Implant reconstruction, however, works extremely well in small breasted women and the new implants are very natural. The issue is that implants are artificial devices and have a known failure rate over a period of time.... more

What is the Optimal Breast Reconstruction?

The optimal breast reconstruction is a choice based on each patient's individual situation. You are having bilateral prophylactic mastectomies and have not indicated that you have any medical issues that would preclude you from choosing any of the many breast reconstruction procedures available. I tend to favor autologous breast reconstruction techniques as they don't use breast implants, and they make a warm, soft, natural breast using micro-surgical transplants of your... more

You have multiple options based on you tissue,size of your breast and your expectations

I do offer both autologous breast reconstruction and implant reconstruction to my patients. The best result in long run can be achieved with the autologous breast reconstruction.You do not have to worry about the implant leak or rupture. I offer my patients DIEP flap if they have abdominal tissue for reconstruction. The advantage of the DIEP flap is ease of recovery and no abdominal muscle is used. If you want to have quick recovery and plan to have pregnancies in the future,I would... more

Kamran Khoobehi, MD

28 reviews

New Orleans Plastic Surgeon

Implants vs. Tissue for Breast Recontruction After Prophylactic Mastectomy

Very hard to advise over the internet. This is a very personal decision that should be based upon only in person evaluations with your reconstructive surgeon. Each has its positives and negatives as to results and risks. To directly answer the last part I recommend natural reconstruction for a more natural "feel' But the risks of the longer surgery time and poor results need to be fully understood. Good luck.

Immediate breast reconstruction with implant after prophylactic mastectomy

Reconstructive options have improved tremendously in recent years due in large part to the use of acellular dermal matrix such as Alloderm to make an internal bra to support implants. This is an especially good option for nipple-sparing mastectomy and would lead to the quickest recovery. Thin patients may not have enough tissue for reconstruction with flap procedures using your own tissue, and these are much bigger operations.

Immediate breast reconstruction

After a nipple and skin sparing mastectomy, you could have an immediate reconstruction . If your surgeon has the experience, the muscle could be expanded with the use of Surgimend (or similar collagen graft). The impland could then be placed under the muscle and graft. The size depends on your size. It does not have to be large. The skin will the be closed over the newly made mound. That technique usually works the best with the least amount of complications. I usually leave flaps for back... more

Breast Reconstruction

Your own tissue feels moore natural and needs less maintainance on the long run. ow ever the surgery might be more extensive depending on which tissue transfer you choose. You need to discuss all these issues with your plastic surgeon ahead of surgery. Disuss each option 1: implants 2: Laismus Dorsi flap 3: Tram flaps 4: DIEP flaps 5: Other free flaps The pros and cons of each and the risks benifit ratios, then you can make an intelligent decision more