Have you been tested for BRCA? I would start with that. If you want to
pursue bilateral mastectomies after doing that, I would suggest a consult
with myself and the breast surgeon I work with.
We would determine whether nipple-sparing would work for you. Since you
already have implants, immediate reconstruction without expanders is a
I am happy to see you for a consult to help get the process started.
Let me know...
In general, breast reconstruction after total mastectomy for prevention can be accomplished through the use of implants that go under the muscle or through the use of tissue from other areas of the body depending on the context of the patient.
That being said, it is possible to perform nipple-sparing-mastectomy, and proceed directly to implant reconstruction. The decision would partly depend on your individual circumstances, and the evaluation by a qualified plastic surgeon. There is a chance that tissue expanders might be indicated to get the best result. There might also be a role for using a decellularized sling to reinforce the reconstruction, whether going straight to implant or using tissue expanders. In my hands, either approach does not significantly change how the surgery is. Results can be very good to excellent.
I hope this is helpful. Good luck to you.
Dr. W.G. Miles
From your question, it is apparent you are contemplating a nipple sparing mastectomy. This is a well accepted procedure not only in patients with your history, but also in patients with malignant lesions, provided the tumor is not in proximity of the nipple/areola and biopsy inside the nipple during surgery is negative. Usually, the breast can be removed through an incision placed around the lower half of the areola . Without getting too much into surgical detail, generally the outcome is aesthetically pleasing. Of course other procedures may be needed at the same time such as a breast lift, padding with soft tissue or by other means. Good luck to you.
Hope that helps answer your question.
Best of luck
Dr. Herbstman, MD FACS
You would need to come in for a complimentary consultation to discuss this with the doctor. However, just to let you know, he does not perform
Jacobson Plastic Surgery
William A Stefani MD