Prophylactic bilateral double mastectomy with immediate reconstruction. Direct to implant, over the muscle. Is this normal?

Hi, I recently had the above done because I am brca2 positive. I am 2 1/2 weeks out and I still am experiencing pain and Tightness in both my breasts. My left breast is larger than my right regarding how it feels with the silicone implant. The pain every day I wake up gets worse. Recently the mesh broke inside and rolled up into a ball onto the top of my breast and feels like it is a bunched up rubber band? Plastic surgeon says it's ok. Is all of these feelings normal? They say it's not serious

Doctor Answers 3

Breast reconstruction

Breast reconstruction with direct to implants is often done with nipple sparing mastectomies but not always. Many times mesh or cadaveric dermis is used to hold the implant in place if it is placed under the muscle as well. It is hard to say exactly what kind of reconstruction you had but close follow up is very important and if things feel or look different, should prompt follow up with your reconstructive surgeon. Best, MMT

Prophylactic bilateral double mastectomy with immediate reconstruction. Direct to implant, over the muscle. Is this normal?

Thank you for your question and congratulations on your surgery. I am sorry to hear that you are having these recovery issues and I would continue to communicate with your surgeon about your symptoms.  Though direct to implant reconstruction is acceptable (typically in small-breasted patients) it needs to be vigilantly monitored for any signs of skin breakdown, irritation or other issues.  Depending on the scaffolding mesh used this may need to be repaired.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Breast reconstruction

Reconstruction of the breasts are often associated with some discomfort post-op. How much is normal is variable. If you are concerned, then I suggest you see your surgeon.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

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