Why Would Implants After Skin Sparing Mastectomy Be Smaller Than The Surgeon Said They'd Be?

Question

I had a skin sparing mastectomy due to the BRCA 2 gene. I am about 5'1" tall and about 125lbs. My expanders were filled to 500cc and they looked huge. I had silicone implants put in at 450/500 both sides two days ago and they look so small. My surgeon said they would give me a full C cup, but they barely look an average B cup. I'm so disappointed. I was a C cup prior to this and I wanted to stay that way. Will they fill out to a C cup after they settle?

Christopher V. Pelletiere, MD · Answer

Aftter undergoing breast reconstruction with tissue expanders and then implants, it is not uncommom for women to feel like they are smaller then they wanted to be. This is due to a number of reasons. The first is that most surgeons always try and overexpand the tissue expanders, so that when the implant goes in there is plenty of room for the implant to sit natural, and therefore is soft and acts like a normal breast. The goal is to get the patient to the exact size they desire, and then over expand 50 - 100cc However, in doing so, women get used to seeing themselves at that larger size. Even though they know they are going to be smaller than the expander, it is hard sometimes when they have gotten used to that larger size. The other reason is that the dimensions for the implants do not match the expanders. All of the expanders project outwards more than even the highest profile implant in that volume. Because of that, even with the same volume, women can feel that they look flatter than they expected. Why the manufacturers do not make implants that correspond to the expander dimensions is still a mystery. Whether they will settle and fill out more is unknow, but I would give your self three months of healing and see where you are at then. I hope this helps.

Vivek Bansal, MD · Answer

At 5ft. 125 lbs., those are a lot of implant. Once they settle down, and the swelling subsides, you should have a more acceptable outcome. Also, the bigger you go, the higher the complication rate. If they are behind the muscle, the muscle needs to stretch a bit to adapt to the implant. Allow 6-8 weeks for adaption to occur.

Why Would Implants After Skin Sparing Mastectomy Be Smaller Than The Surgeon Said They'd Be?

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