My breasts are too saggy to consider nipple sparing mastectomy. Do I need a breast lift before I have the PBM?

Thank you for your question and photographs and I wish you the best on your breast cancer treatment.  Unfortunately without the full details of your cancer diagnosis, it is difficult to offer you the best treatment recommendation.  In general, however, breast sagging does not prevent you from a nipple sparing mastectomy.  Criteria for NSM depend more on the size, number, and locations of the cancer in your breast as well as a lymph node examination.  Speak to your oncologic breast surgeon about your options.  They will be your best advocate for working with a plastic surgeon for your treatment and reconstruction. 

Thanks you for your question and best of luck with your treatment.I performs many risk reducing mastectomies and I would tend to not perform a nipple preserving operation on someone with the degree of droop you have.You would be suitable to have reconstruction with implants and dermal sling, which uses the skin on the lower part of the breast to support the implant.I hope this helps Best Wishes