How can I ensure healing fully after double mastectomy direct implant reconstruction. (photo)

I am very sorry you are having to go through this. Based on your photos, the skin is very compromised and may not survive. It is difficult to guide you further other than to say that local wound care with antibiotic ointment or comparable is the best thing to do right now. You may need further surgery once any area of loss declares itself. You might need your implant removed (just so you are emotionally prepared). I recommend seeing your plastic surgeon weekly during this difficult time. Best wishes.

Unfortunately with nipple sparing mastectomy there is always the possibility of loosing skin or loosing the nipple areola complex.Based on the ppicture posted, the dark skin in the lower part of the breast id dead skin and will be lost. The white skin around the nipple areola is possible full thickness loss of skin. I doubt that the implant can be saved.There are few options1: remove the implant, debride all necrotic skin and let it heal. 2: Remove the implant debride all necrotic tissue and if there is no infection flap reconstruction or a Latismus Dorsi Flap with or without an implant or tissue expander.

It looks like you have some skin necrosis of the flaps and possible nipple issues. Best to follow the wound care of your surgeon..