What will my result be like after Mastectomy with immediate implant reconstruction at 350 cc? (photos)

Hi I'm BRCA1 and have got my bilateral (preventative) mastectomy with immediate implant date through. I'm wandering how I can expect my result to look . I'm 5foot7, 120lbs . Shoulders 19 inches . Underbust 31 inches across the bust 36.5 inches. I have already had a breast lift in preparation . what cup size to expect with 350 cc implants ? Also I'm told to expect rippling due to my size . If i have some fat along with tissue will they take both away as I have gained some weight.

Doctor Answers 1

Tassos Dionisopoulos MD

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thank you for your question. i am happy to see that you will be undergoing your preventative mastectomy in order to reduce your chances of developing breast cancer. unlike breast augmentation surgery where the plastic surgeon is in control of all aspects of the surgery and thereby able to offer a fairly reasonable prediction of the outcome, breast reconstruction involves a myriad of variables, many of which impact on the ultimate aesthetic outcome.  for example smoking will increase chances of severe complications with wound healing problems and sometimes skin viability. other variables include the type of mastectomy (ex nipple sparing VS skin sparing) ; the 'thickness of the skin flaps after the mastectomy is performed; the type of breast implants (more-so than the volume in mastectomies); whether the implants are placed beneath the muscle or in a 'pre-pectoral' location and whether ADM (acellular dermal matrix) is used. Of course cup size is an inaccurate and inconsistent measure of breast size and so we cant promise or predict that. we are working with the "look" of the new breasts. breast implants come in a variety of different gel consistencies and shapes (low height-->high profile) thus offering more choices. 

as i see your picture and hear and read your description, you would be a good candidate for a nipple sparing mastectomy, especially since your breast lift procedure has repositioned your nipples more on the centre of the breasts. 

my preferred approach would be a direct-to-implant immediate reconstruction with silicone filled cohesive gel implants. i would use ADM to cover the implant and place the prostheses in the pre-pectoral pocket and not under the muscle in order to avoid animation deformities. depending on the thickness of the skin flaps and how everything interacts with the implant, you may or may not need further fat grafting. the goal would be to select the proper implant based somewhat on intraoperative conditions to also fill the upper part of your breasts as well. 


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