Silicone Implants After a Bilateral Mastectomy? (photo)

Question

My plastic surgeon expanded my tissue expanders to 750 ccs, then replaced them with 700ccs cohesive gel silicone implants. Before the exchange surgery, I was wearing a 36 D sport bra. Although I can still wear the same size bra, they do not appear to be what I thought.They certainly appear much larger in a photo.....little projection, but full.Is this natural?

Brian K. Reedy, MD · Answer

The photos appear to be very early in the post-op period and pretty normal at this point.  Unfortunately, almost all breast reconstruction patients exhibit less projection than ideal.  It is the nature of the mastectomy and the inherent softness of the gel implant.  There are high profile and newer ultra-high profiles that can help.  In addition the true cohesive gel, form stable implants can maintain better projection in some patients.  At this point, I would not do anything.  Let them settle and heal.  In 3-6 months if you were still unhappy, an implant exchange to change volume, type, shape, and projection should be an straightforward 30 minute operation with little downtime.

Francis X. Fleming, MD · Answer

Allergan now makes a smooth round cohesive gel implant that will give you more projection and be a little softer the the textured anatomically shaped implants.

Lewis Albert Andres, MD · Answer

It is common to overexpand your tissue expanders prior to your second stage breast reconstruction.  This amount of overexpansion is typical, along with accounting for the size of the port within the expander in that volume.  Depending on which projection expander was used and which implant projection was used will also determine the amount of projection that you have during and after your reconstructive procedure, respectively.  It is common to have a little less projection with the implant than with a tissue expander, since the expander is doing just that - expanding your tissue.  Once your final implant has been placed, it will have a softer, lighter, and more natural feel and appearance.  

	Looking at your photo, it appears that you are recently postoperative.  This flattening is usual, especially since your previous atop the breast was used.  Allow the swelling to subside and the implants to settle for several months before your final results will be seen.  Thank you for your question!  Hope this helps!

M. Scott Haydon, MD · Answer

One of the difficult thing about expander reconstruction is that the implants do not have the same projection outward as the expander itself. The expander is engineered to maintain continuous outward pressure to establish the pocket and prevent collapse. The downside is that the expanders become more firm when volume is added. This however goes away when the implants are placed.With regard to bras, the lack of outward projection means that most cups don't get filled completely. There are some bras, like Tshirt bras, that don't have as conical a shape. Many people wear camisoles with the shelf built in since you don't often need as much support. Hope this helps.

Robert Whitfield, MD · Answer

It is a little early to tell what your final result will be so I would be patient.  Those are very large implants so time will tell in terms of your feeling in clothing and out of clothing.  There are other options if decide this is not how you feel most comfortable.

Silicone Implants After a Bilateral Mastectomy? (photo)

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Answer: Reconstructed breasts often do not fit traditional bras

Answer: Reconstructed breasts often do not fit traditional bras

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Silicone Implants After a Bilateral Mastectomy? (photo)

Answers (9)

Answer: Reconstructed breasts often do not fit traditional bras

Answer: Reconstructed breasts often do not fit traditional bras

Answer: Breast Reconstruction

Answer: Breast Reconstruction

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Recommended reading

Everything you need to know about Breast Reconstruction

Our mission is to create a world where every investment in modern beauty is Worth It.