Double Mastectomy with Breast Implants

I recommend you seek a second opinion as a woman with C cup breasts should be able to get larger implants than those resulting in an A cup. Whether you get tissue expanders vs.. direct to implant will require an in person consultation with a board certified plastic surgeon

It is unclear what you mean by the veins being too small. If you are getting a DIEP flap, your surgeon can do pre operative imaging in the form of a CT scan to assess the quality of the vessels.

If you have a small amount of abdominal tissue sometimes a “hybrid” reconstruction is performed where your abdominal skin and fat is used along with a small implant. Please speak to your surgeon about all of these options.

We do not know the reasons for your mastectomies, cancer, precancer or if you will have radiation or not. We do not know what exactly your surgeon told you or what you understood by it. It can be confusing. There are many ways to reconstruct a breast. A microvascular DIEP flap is one way and so are implants with tissue expanders first. The surgeon told you if the vessels are not adequate, a DIEP may not be possible. This is true. Then if the tissues in your chest are too tight because of the mastectomy, then a large implant is not possible to insert and then you may need a tissue expander first. This is also true. A CT scan may give a better idea but your surgeon may feel it is not adequate and may not recommend this routinely. Tissue expanders do not cause any more discomfort than anything else. We know you are scared and confused and this is normal. DIEP flaps are not done by charlatans. See your surgeon and have all explained to you again. The surgeon wants to help you.