5'5", 106 lbs, 34B, breast cancer on left side. What are the best surgical options? (Photos)

Question

I was recently diagnosed with breast cancer on the left side. I'll be doing chemo but there's no guarantee it'll get me to a lumpectomy - and even so, I worry that if I have a recurrence after radiation, no plastic surgeon could save my tissue for a 'natural' (nipple, skin, etc) reconstruction. Which brings me to considering a single mastectomy. I am 5'5", 106 lbs, I was a 32D but some hormone changes last year shrunk me to a 34B (not super happy about that). I am also a nude model and have a vested interest in my looks as well as nerve sparing/grafting techniques - not just for hot and col but full on "let's save the sexy parts" desire to save or bridge the intercostal nerves to the NAC for erogenous sensation. I guess that makes me high maintenance. What should I be looking for in surgical options for my size and interests?

Yucel Sarialtin, MD · Answer

Dear neurotic_me,
I am very sorry to hear about your recent diagnosis. Facing breast cancer is incredibly daunting, and your proactive approach to understanding your reconstructive options is commendable.
Given your profession as a model and your strong desire to preserve both aesthetic appearance and nerve sensation, you are dealing with conflicting priorities in oncological surgery. The absolute primary goal of a mastectomy must always be the complete removal of cancer.
Here is the clinical reality regarding your specific concerns:
Nipple-Sparing Mastectomy (NSM): This offers the best aesthetic outcome, preserving your natural skin envelope and nipple-areolar complex.
However, oncological safety dictates whether you are a candidate; if the tumor is too close to the nipple, it cannot be saved.
Sensation and Nerve Grafting: You mentioned a critical desire for nerve-sparing or grafting techniques to maintain erogenous sensation.
While advanced microsurgical techniques exist and can restore some protective and touch sensation over time, restoring full erogenous sensation is highly unpredictable and often impossible.
No responsible surgeon can guarantee the return of sexual sensation after a mastectomy.
Symmetry and Single Mastectomy: You are considering a single mastectomy.
Achieving perfect symmetry between a reconstructed breast and a natural breast&mdash;especially starting from a 34B&mdash;is one of the most difficult challenges in plastic surgery.
The natural breast will continue to change over time, while an implant reconstruction will remain static.
Many patients opt for a contralateral balancing procedure (a lift or augmentation/reduction) on the healthy breast to ensure symmetry.
You need a multidisciplinary team: a breast surgical oncologist and a board-certified plastic surgeon specializing in complex reconstruction. You must have a very frank discussion about what is anatomically possible versus what is oncologically necessary.
Wishing you strength and the best possible outcome on your journey.
Best regards,Op. Dr. Yucel SarialtinPlastic, Reconstructive and Aesthetic Surgeon

5'5", 106 lbs, 34B, breast cancer on left side. What are the best surgical options? (Photos)

Answers (1)

More Breast Reconstruction Questions

Implant fold raising skin - Revision Reconstruction needed? (Photos)

Axillary fat excision - how far around the breast will the scar go?

Breasts dislocated - how can this be fixed? (Photo)

Scar tissue build up after implant removal - how can I create symmetry? (Photo)

Congenital symmastia or possible result from early heart surgeries? (Photos)

Implant Exchange to Mentor Boost 775

WE SEND PRETTY
EMAILS