Extra Skin Left After Prophylactic BM? What Are My Options For Reconstruction? (photo)

Thank you for your question and the photos. Yes, this is a typical look after mastecomy in a women that before surgery has 38DD breasts.  This can be addressed by a plastic surgeon at the time of breast reconstruction if you choose to have reconstruction.

Also, if a plastic surgeon is involved from the very beginning, there are alternative incision patterns, such as an inverted T skin reduction pattern, that can be used by the plastic surgeon to help alleviate your problem of excess skin and help make things look better.


If you are interested in breast reconstruction, complete all of your treatments that are necessary (chemotherapy and/or radiation therapy) and make sure you have clearance from your cancer doctors (oncologist) to have breast reconstruction. Then, see at least two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery.  I hope this helps.

Too bad to not have a consult with a plastic surgeon before your mastectomies.  It may be a good idea now to go speak with someone about the options.  Leaving the extra skin is OK. If it turns out not to be of adequate quality during reconstruction it can always be discarded. At present since you are early post-op, this tissue is likely swollen and things need to settle down a bit.

Many large Plastic Surgery volumes were written on this very topic and the space and time allowed cannot address all of your options.

Most commonly the ideal Breast Reconstruction begins BEFORE the maatectomy. The breast surgeon and Plastic surgeons cooperate and plan the incision pattern as well as WHICH reconstruction path, out of the many ones available, would be taken. Your health, your future radiation / chemotherapy treatments, your weight, your desire for breast implants VS. use of tissues (and scars on ) other parts of the body are ALL important considerations.

At this point, you still have a lot of options available to you once the inflammation from the surgery resolves. Ask your breast surgeon give you the names of several Plastic surgeons and visit them, even if you have to pay out of pocket. Once you met them and learned YOUR options, you can decide which option and surgeon you like best. This way, you will be ready to proceed when the tissues soften to complete the reconstruction which best suits your  goals and beliefs.

Peter a. Aldea, MD

You certainly have many options for breast reconstruction on a delayed basis.   A consultation with a plastic surgeon will help you understand your reconstructive options.  

If you want future reconstruction the extra skin will be a large help in giving you a more cosmetically pleasing reconstruction.  You can choose many different types of reconstruction bases on your medical problems, body type and need for radiation treatment.  You may choose to do tissue expanders with implants or use your own tissue for reconstruction ( like your tummy).  If you do not want reconstruction then you will most likely want another surgery to remove the extra skin from your chest.

If you are looking at getting breast reconstruction, the extra skin can either be removed or used to cover implants.  Note that your creases below the breasts were preserved and this will help you have a better result.  If you don't plan to make new breasts, the extra skin can be removed to tailor the chest wall better.