Any new creative options to be aware of for breast reconstruction?

Question

I am in the consultation stage of getting a prophylactic mastectomy with reconstruction, following a diagnosis last year of BRCA2 mutation. I am wondering if there are any new techniques or options to be aware of.

Ryan Rebowe, MD · Answer

Many women considering a prophylactic mastectomy would benefit from a nipple sparing procedure in order to achieve the best postoperative cosmetic outcome. However, many women who are of the age to consider mastectomy have too much ptosis (breast drooping) to be considered for this procedure as lower nipples are predisposed to postoperative ischemia (death from lack of blood supply). However, if there is no current diagnosis of cancer then you may be a candidate for a staged procedure in which you initially receive a breast lift (mastopexy) to raise your nipples followed by a nipple sparing reconstruction. This increases the chances that the nipples will live following the mastectomy and can also improve the cosmetic outcome by improving the shape of the breast. Of course, consultation with your plastic surgeon will determine if you are a candidate for these staged procedures.

David Branch, MD · Answer

Yes, well I'm not sure how up to date you are but a lot has changed over the last 20 years. today's mastectomy and reconstruction is entirely different from that of your grandmother's generation. Primarily, loss of the nipple and areola is no longer necessary unless a tumor is invading this structure. A nipple-sparing technique with an incision only underneath is now standard of care unless the breast is very large or droopy. Otherwise a reduction or lift pattern can be used for the mastectomy and the nipple replaced as a graft. Lastly, safer implants and fat shifting have made the expectations for the "normal" appearing reconstruction actually a realistic result.

Gary M. Horndeski, MD · Answer

The technique I recommend is where the breasts are scanned pre-operatively and then a skin pattern called The Bellesoma Method is used for the mastectomy.  This allows the incision to be hidden in the inframammary fold at the time of the reconstruction.  It does not require the patch of skin or vertical scars.  Depending on the nature of your surgeon, he may or may not be able to spare your nipple.  With this technique, the nipple can be spared.

Best Wishes,

Gary Horndeski, M.D.

Alan Gonzalez, MD, FACS · Answer

Hello @oreogirl, thank you for your question. Since every case is different and multiple factors must be taken into consideration in order to plan a successful surgery, you can consult in a personalized way. There are some techniques that allow reconstruction based on a plan adapted to the recovery process. Best wishes! Alan Gonzalez MD, FACS.

Neil Tanna, MD, FACS · Answer

There are absolutely new techniques to consider:a. nerve reconstructionb. hybid breast reconstructionc. robotic reconstructiond. robotic mastectomy

Any new creative options to be aware of for breast reconstruction?

Answers (8)

Answer: Any new creative options to be aware of for breast reconstruction?

Answer: Any new creative options to be aware of for breast reconstruction?

Answer: New techniques

Answer: New techniques

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.

Any new creative options to be aware of for breast reconstruction?

Answers (8)

Answer: Any new creative options to be aware of for breast reconstruction?

Answer: Any new creative options to be aware of for breast reconstruction?

Answer: New techniques

Answer: New techniques

Browse related questions

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.