Can my breasts look anything like these after prophylactic bilateral mastectomy? (Photo)

the first image is a reconstructed breast. Can I achieve this without a t scar? I am currently a 34D

Doctor Answers 3

Bilateral mastectomy

Thank you for your question!

I'm sorry to hear that you need a mastectomy and reconstruction. 

I perform many breast reconstructions in a one-stage fashion without extra scars. However, a d-cup breast with ptosis would be concerning due to bloom supply to the nipple. You would also have to be cleared by your oncologist to allow for a nipple sparing mastectomy which is usually the case with prophylactic surgery. 

If you are not interested in saving your nipple or cannot for safety reasons, I offer a procedure that allows you to spare your muscle and decreases your pain after surgery called autoderm. 

The best way to assess and give true advice would be an in-person exam.

Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr Schwartz

Prophylactic mastectomy

The first photo that you have shows a patient that has no excess skin or sagginess to her breasts (ptosis) and was probably small in size to begin with.  Your breasts do have some ptosis and have a looser tissue envelope.  Plus, you are larger in size.  So, comparing the two breasts is like comparing apples to oranges, unfortunately. 


A prophylactic mastectomy with immediate tissue expander reconstruction can be done for you.  Often, the pocket of tissue tightens after the mastectomy, and may even do so enough to preclude you from having a lift procedure done (the inverted T scar).  However, that usually will not be known until after you have had the expanders in and inflated to your desired size. 


The best thing to do is to talk to a plastic surgeon who does a lot of breast reconstruction.  He or she can guide you in your options and will have a better opinion on your surgical outcomes after they complete a physical exam.

Good luck!

Breast reconstruction

Without an in person exam I cannot tell you for sure but there is or was almost no breast sag in the first photo.  When there ins a degree of sagging or ptosis is becomes more difficult to do a single stage breast reconstruction.  

Three basic forms of breast reconstruction exist. You can use your own tissue, implants or a combination of the previous two techniques. Your own tissue can be used in the form of the DIEP flap, PAP flap, SGAP flap or fat grafting. Implants can be done in one stage or two stage. Two stage reconstructions are started by placing expanders at the time of mastectomy. Once they expanders are placed they are able to be inflated as determined by wound healing. The final type consists of combining any of the above techniques.

If you are interested in being seen in Austin, Georgetown or New Braunfels please give us a call. I know this is a difficult time for you. The majority of my practice is devoted to reconstruction for women with breast cancer or who are BRCA+

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