Is a 32A to a 32C/D Unreasonable for a Bilateral Mastectomy Patient?

I am 5'3, 98 pounds, large 32A. Finishing chemo in 1mo and am debating radiation vs. bilateral mast. I have had a consult with a PS who highly discouraged going from a 32A to a large 32C (which I would like, why not). He said at max he would recommend 400cc's which would bring me to a large B. Going to a large 32C would bring more complications? Im concerned about rippling bc i'm thin. The PS also said silicone implants, in his hands, had higher rates of cap. contracture. thoughts? Thank you!

Doctor Answers 3

Obtaining larger breast size after mastectomy

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Your desires are reasonable following your mastectomies to increase your cup size.  An examination and evaluation by a board certified plastic surgeon who focuses on breast reconstruction would be able to assist you in determining the best reconstructive option for you as well as expected outcomes following your procedure.  One of the most important determinants for breast size would be your breast width as well as the tissue laxity following your mastectomy.   Both implant-based and flap-based procedures would be able to increase breast size.  

First of all, if you did have radiation after your procedure/chemotherapy, I would recommend autologous (your own tissue) reconstruction.  If you did not require radiation, either option should be available to you, but certainly tissue expanders may be the wisest option, especially since you would like to increase your breast size.   Also, by use of the expanders, you would be able to see on a week-to-week basis your breast size and let your surgeon know when you are happy with that size.   Use of tissue expanders alone, or with a latissimus flap are viable options and could add significant size.  Given your small body habitus, abdominal tissue may not be the best option to increase size for you.  

In regards to the implants, both are great options.  Saline implants tend to have more visible rippling than silicone implants, especially in those who are very thin.  Capsular contracture rates are similar for either implant.  Hope that this helps!   The majority of all women who undergo breast reconstruction are overall very pleased with her decision and her results.  Good luck!

Breast reconstruction after mastectomy

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I think you reconstruction depends upon many things.  1) what type of post-op treatment you will have, 2) what your anatomy is like,3) your mediclal history to name a few.  I prefer autologous reconstruction for most people.  Tissue expander of even immediate to implant reconstruction is possible.

Immediate one stage breast reconstruction with silicone gel implants and acellular dermal matrix

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Without knowing more of the details of your case I would suggest by you breast measurements that a certain volum can be reached based on the weight of the mastecomty plu 10 to 20percent more.  Based on measurement I use that to guide what implants make sense and have several options available in the operating room including sizers to help guide my selection.  It is also criticcal to mark the lateral border of the breast try and recreate this landmark so the appearance is as close to normal as possible.

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.