I'm getting a prophylactic mastectomy and I was wondering what size implant(maximum number of cc's)you'd recommend for reducing the risk of potential problems and especially future sagging.
Safest Size Implant to Avoid Sagging Post Mastectomy?
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Sagging breast implants after mastectomy
Thank you for your question. The answer to your question depends on how much healthy tissue you have left after the mastectomy and the base diameter of your implant. If you opt for a tissue expander prior to implant, the size is adjustable and can be dialed in to a size that you like. Acellular dermis may add an extra layer of support.
How to pick implant size for reconstruction after mastectomy
While it is true that too large an implant will be prone to sagging and related problems, the answer to what the largest size is will depend on the patient. Most important is the base diameter of the breast, which your plastic surgeon will measure. It is often a good idea to use Alloderm for an internal bra to add additional implant support.
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Drooping after mastectomy
In general, a plastic surgeon may ask you what size you would ultimately like after mastectomy, but an experienced and safe surgeon will only place the "safest" size implant that will accomodate the mastectomy defect. The larger the implant you place in that pocket, the more chance for complications and wound healing problems, since any significant pressure (either from within or externally) will affect the blood flow to the skin flaps. Skin flap circulation is decreased from any total mastectomy procedure, so it would be prudent not to compromise the circulation in any way. Finally, future sagging will depend more on the quality of the breast skin as well as the internal support to the implant, rather than the size of the implant.