Do the Skin Flaps from Mastectomy Grow Thicker over Time? (photo)

Question

I had bilateral skin and nipple sparing mastectomy with immediate reconstruction with 800 cc silicone implants in July.I am unhappy with the appearance of my breasts. I had 600 cc overfilled saline before my mastectomy and was very happy. I have been told by my plastic surgeon that my flaps are too thin for overfilled saline implants now. Will my flaps thicken over time so that I may eventually have overfilled saline implants?

Amy T. Bandy, DO, FACS · Answer

Hi Lexi, thank you for your photos and your question. The answer in short is no, the flaps will not grow thicker, and in fact may become more thin over time from the pressure of the implants. Unlike breast augmentation where you have normal skin, fat and breast tissue & muscle covering the implant, after mastectomy, the only thing covering the implant is a very thin layer of fat and skin and muscle. The results that you got are excellent. I am sure that if you look hard enough, you could find someone to change your implants, but I truely think that you would regret it because you would have a very high liklihood of implant rippling and palpability and poor cosmetic results. Good luck!

Peter A. Aldea, MD · Answer

One of the reason why many Plastic surgeons do not do breast reconstruction is because of very high expectations; As good as the reconstructed breast may be it is rarely as attractive and feels as normal as the breast which had to be removed for cancer.

	Skin flaps do NOT thicken with age but actually thin further. A saline implant is heavier and ripples more than a same size silicone gel filled implant. as a result, placing a saline implant would result in a rippling of the breast and quicker sagging.

	The only thing which MAY be better would be reconstruction with your own tissue such as a DIEP flap. Discuss it with your surgeon.

Kamran Khoobehi, MD · Answer

You can nit compare the reconstruction result to the augmentation.Mastectomy has removed your breast tissue and very thin layer of skin left.

Darryl J. Blinski, MD · Answer

Without a before photo I must say that for a reconstructed breast you have a very acceptable result. No skin flaps do not thicken over time. Discuss with other PSs in your area.

Samir Shureih, MD · Answer

The skin flaps will not thicken. May be fat transfer will do that. Fat transfer is not covered by insurance and you will pay for it. you will need multiple sessions.

	Remember you had mastectomy therefore you can not compare your breast before the mastectomy to the breast after the mastectomy.

	Other options is latismus flaps to thicken the coverage to the implants. This will put a SCAR across your back.

Do the Skin Flaps from Mastectomy Grow Thicker over Time? (photo)

Answers (5)