Unilateral mastectomy - Small breast implant on one side only?

Question

I am about to have a unilateral Right mastectomy, and am a size AA cup (75cc?). I was told by one plastic surgeon that I could choose to simply have an implant in my removed breast, but other plastic surgeons say that's not possible (i.e. that I would have to go up dramatically on the Right because there are no implants small enough). Is that true? Or could an 80cc implant do the trick. I've also been told that if I wanted to augment a little (I would never want to be more than an A and would prefer a little smaller) that that is not possible. That I'd need to be 100 on the Left and 175cc (I'm making up these ratios as an example) on the Right. Is there no way for women who are contented with their small breasts to remain small after a Mastectomy? It seems like society assumes everyone wants to be larger. Many thanks for your insights.

Michael A. Fallucco, MD, FACS · Answer

Thank you for your thoughtful question, this is a concern I hear often from patients facing unilateral mastectomy with smaller breast sizes. The good news is that it is possible to maintain a small breast size after mastectomy, including using implants in the range of 75–80cc if that matches your natural breast volume. Advances in implant technology mean there are very small, low-volume implants available that can help achieve good symmetry without drastically increasing size.

However, achieving perfect symmetry can be challenging when one breast is reconstructed and the other remains natural, especially if the natural breast is quite small. Often, the reconstructed side may require a slightly larger implant to match the shape and projection of the natural breast, which is why some surgeons suggest larger sizes on the mastectomy side paired with volume adjustments (or reductions) on the natural side. But this doesn’t mean you have to go “dramatically” bigger if your goal is to stay small, it really depends on your individual anatomy and what your surgeon can achieve through pocket placement, implant selection, and possibly minor adjustments on the opposite breast.

If you’re comfortable with your natural breast size and prefer to stay within that range or even smaller, it’s important to communicate that clearly with your surgeon. Some patients choose to undergo procedures on the opposite breast, like a lift, reduction, or even a small implant, to achieve better symmetry without increasing overall size. Ultimately, the goal is to tailor the reconstruction to your preferences, not societal expectations.

So, yes, an implant around 75–80cc could very well “do the trick” depending on your chest dimensions and soft tissue, and there are options to maintain a small, natural profile after mastectomy. It’s absolutely possible to stay small, and your surgical team should work with you to respect that priority.

Rajaie Hazboun, MD, MBA · Answer

Thank you for posting your question here!My answer will be based on the limited information provided and lack of pictures, for a more detailed and personalized answer I would recommend consulting with your plastic surgeon in person.I am sorry that you are going through a mastectomy, I understand that you are going through a lot . The problem is the issue of reconstruction is complex , it is hard to weigh in without being in on the plan and knowing what the surgical oncologist is planning on etc. Implants come in a lot of shapes and sizes , and you are right , the smallest is around 80cc. One of the main issues is that when having a mastectomy the breast structure will be removed, the implant will define the new breast shape and will likely have little tissue over it to mask it . implants are usually round and that might be different from the opposite breast. so in many instances you have to address the discrepancy by operating on the opposite breast. That being said there is no need to go dramatically big when reconstructing , you can always use a combination of implants and fat when appropriate or when that option is available, the smaller the implant the less stress there is on the mastectomy flap/skin . That all being said , your surgeon will always try to tailor the plan to your needs and wants and your priorities , so I would encourage an open discussion with your surgeon so that they will understand what you want and see if that is achievable .I hope this helps, best of luck!

Prakash Mathew, MD, MBA, FACS · Answer

Hi,Implant selection starts with your breast’s base diameter&mdash;the width of your natural footprint on the chest wall&mdash;because a proper fit prevents visible edges or bulging. For someone with a petite frame, one of the smallest Mentor silicone implants (130 cc, 8.8 cm base diameter) usually matches that footprint; its low‑profile shape keeps projection minimal, and we can layer a small amount of your own fat around it&mdash;or even rely on fat grafting alone&mdash;to fine‑tune volume.
Hope that helps!

Unilateral mastectomy - Small breast implant on one side only?

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Unilateral mastectomy - Small breast implant on one side only?

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Our mission is to create a world where every investment in modern beauty is Worth It.