How much bigger than your natural breast size can you go with direct-to-implant breast reconstruction?

Thank you for your good question. Performing a direct-to-implant breast reconstruction will depend on a number of factors, including how big you want to go. Patients that want a similar breast size may be able to do the reconstruction without expanders, eliminating one of the surgical steps. However, if you are looking to increase your size significantly, chances are the use of expanders will improve both the safety and the success of your procedure considerably. I recommend a visit with a board-certified plastic surgeon with ample experience in breast reconstruction techniques that can assess you in person and discuss your aesthetic goals to create a surgical plan that will meet your needs best. Good luck with your upcoming reconstruction. 

With direct to implant reconstruction, you are limited in the size change.  By attempting to place a much larger implant, it will compromise the blood supply to the skin causing healing complications.  To go larger, you would need to have tissue expanders placed.  This allows for healing before beginning the expansion process.  There are an increasing number of options available to you.  Please find a board certified plastic surgeon who specializes in breast reconstruction to explain the options to you.  Good luck with your upcoming surgery.

Dr. E Wright

It really just depends on your skin quality and how big you are now and how big you want to be. If you are smaller breasted and want to be larger you will need to be expanded first most likely. If you don't care about being small then it may be fine to go direct to implant. If you are a nipple sparing case it makes it a lot easier to go direct to implants because it you save a lot more skin. If you have the nipple and areola removed lots of skin is removed and there is a lot less skin to allow an implant. 

thank you for your question. This is a very common question that I get asked by my patients. 
being able to place an implant immediately after mastectomy depends on several factors and to me the most important factor is the status of the blood supply to the skin after mastectomy. Your breast surgeon will do whatever necessary to do the best operation for your breast cancer. Reconstruction follows this. 
When I am doing these procedures, I use a machine called the spy to look at the blood flow to the skin after mastectomy. If the blood flow is adequate, then I am able to place the final implant. If the blood flow is not adequate, the patient may get a tissue expander instead. In very rare cases, we are unable to perform reconstruction at the time of mastectomy and will have to come back in a couple of weeks.
I always make my patients who want direct to implant reconstruction  aware that there are those three possibilities after mastectomy. 
Please also understand that even if you get a direct to implant reconstruction, you may need other revision procedures In the future to improve the aesthetic appearance of the breast. 
Please consult with a plastic surgeon board certified by the American Board of Plastic Surgery to learn about all of your options for breast reconstruction. 
Best wishes! 
Rahul Vemula, MD 
Double Board Certified Plastic and Reconstructive Surgeon

Yes, it really depends on how much space you have to put the implant in but you should have enough to place a good sized B or C. Dr. Ed Domanskis