American Society of Plastic Surgeons
For Medical Professionals
Ester L Davis
5 years ago


Prophylactic double mastectomy with reconstruction. Is this done right after the removal of both Breast. Is it implants?

some people say they had problems with the implants and had them removed is that true? Or do you have the implants removed after several years?

Procedure: Breast Augmentation
Location: Columbia, SC

Replies 4

Sergei Vasilyev
ASPS Int. Surgeon

Yes Ester,

The most common way for immediate breast reconstruction after prophylactic mastectomy is placing silicone implants. Because silicone is a foreign body, sometimes it causes conflict with own surrounding tissues which can make your breast firm and destroy aesthetic appearance that is the most common reason for implants revision or removal. Another breast reconstruction option is to use your own tissues (autologous breast reconstruction) which is our favorite approach. Today our breast reconstruction method of choice is autologous fat grafting, which I would recommend in your case.

Steven Wallach
ASPS Surgeon
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The breast reconstruction can be performed at the same time as the mastectomy. This can be performed with tissue expanders and then implants, sometimes implants immediately at the same time as the mastectomy, and sometimes using autologous tissue can be performed as well.

Rahul Vemula
ASPS Surgeon
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Reconstruction can be performed at the same time as the prophylactic mastectomy. There are two main ways to reconstructive breast, one is to use implants and the other is to use your own tissue. There are advantages and disadvantages is to each type. I would recommend meeting with a plastic surgeon who does all aspects of breast reconstructive surgery to figure out what is the best method for you. Also please note that reconstruction is rarely involves one operation and you may need multiple procedures to achieve your goals. Breast reconstruction is a big part of my practice and I make sure all my patients understand all their options. Best wishes!

Rahul Vemula, MD - Plastic Surgery of the Face and Body

Diplomate of The American Board of Plastic Surgery

Diplomate of The American Board of Surgery

Active Member, ASPS

Nelson Castillo

Thank you for sharing your question. For most patients reconstruction involves one or multiple stages with the most common being placement of a tissue expander followed by serial enlargements until the agreed upon size is reached. At that time the expanders are switched for silicone implants. I would recommend speaking with your surgical oncologist and plastic surgeon to get the details of your reconstruction as there are many options available to you.


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