Will I Be Able to Maintain Breast Size After Masectomy and Reconstruction?

Hello, I'm 31 years old and just found out I have stage 1 breast cancer and positive for BRCA1. the recommendations now are to remove both breasts. I know my health is the most important thing but I'm pretty devastated about the face of loosing me breasts. I have large breast which I was always proud of. I'm 34D bra size and my question is, will it be possible with the reconstruction surgery to bring them back close to that size? I met with one plastic surgeon who said that would be a challenge.

Doctor Answers 4

Maintaining Breast Size During Reconstruction

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If you are choosing to use your own tissue:

-this depends on how much of your own tissue that can be spared to recreate a breast.   '

-If you have enough tissue in your abdomen to recreate the volume of your breast, that is your answer

-if you do not have enough tissue in your abdomen, you may be a candidate for a stacked reconstruction, where 2 flaps (usually buttock and abominal) flaps are used to reconstruct each breast


If you are choosing to use an implant:

- this depends on your height, weight, and chest wall width.  

-If you are a large frame woman, it may not be possible to place an implant large enough to fill this volume loss.  

-if you are a small or average frame woman, it should be possible to reconstruct DD breasts with a large tissue expander and implant


Wish you a safe recovery

Houston Plastic Surgeon

Maintain breast size after mastectomy & reconstruction

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I understand that it is devastating to find out that you not only have cancer, but that you will be loosing your breasts at a young age.  Having reconstruction after mastectomy can give you a relatively full breast, but the limit of the size will be the size limit of the implants, if you are going that route.  The largest implants available are 800cc, and in a reconstructed breast, this can be a C-D depending on your chest diameter and body.  The breasts that you will have with a reconstruction will not look the same as a natural D cup breast, but you can get a very beautiful and natural looking result in experienced hands.  I wish you the best of luck!

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 109 reviews

Breast size after mastectomy

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Boy this is a tough question to answer without examining you.  If you want autologous tissue reconstruction( using your own tissue) then you have to fatty tissue on your abdomen, hips or buttocks to transfer up to the chest. If you want implants, then the chest skin would have to be expanded to accomodate the larger implants. Hard to say without the exam.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Post-mastectomy breast reconstruction

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You are a situation of good news-bad news. You have been diagnosed with breast cancer but you caught it early. You have the BRCA gene but a bilateral reconstruction is easier to match than unilateral. Although you show no photos, it is not impossible to get close to your original size using tissue expanders. However, it might be advisable to down-size your thinking because of potential drawbacks with larger implants. However, you could possibly supplement your implant reconstruction with a flap although that is less common in bilateral cases. The important thing is to discuss all options and combinations of procedure with a plastic surgeon to customize your treatment. I would go so far as to say that the plastic surgeon is as important, if not more so, that your oncologic team since he/she should have a vision of your end result and because your treatment options with the BRCA gene are clear cut. It is my belief that patients going for breast cancer treatment can come out fully treate and often looking better than pre-cancer. At least, that is usually my goal.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

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.