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Had mastectomy of right breast. Would it be better to have the left breast removed and both breasts reconstructed with the implants?

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Posted on Wed, 11 Sep 2013
Question: It's been 2 years since I had a mastectomy of my right breast. The Plastic Surgeon and I have discussed Diep Flap but are leaning towards Lat Flap followed by a breast reduction on the left side. I've since thought about the feel and appearance of a single implant as I age or have changes in weight. Would it be better to have the left breast removed and both breasts reconstructed with the implants? What are your recommendations?

Lastly, recommendations or preference on implants, saline or silicone?
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Answered by Dr. Surindher (7 hours later)
Brief Answer:
hello, thank you for your query

Detailed Answer:
Your reconstructive options will depend on the status of the other breast and the desired size of the unaffected breast.

The breast can be reconstructed using a DIEP flap or a Lat.Dorsi flap with an implant. There are a few factors which help us decide....

DIEP:
1. When you have good enough skin in the abdomen for reconstructing the whole breast
2. If the breast size (opp side ) is big
3. If you dont want implants
4. The whole breast tissue and skin is removed.

LAT.DORSI:
1. In skin conserving mastectomies /lumpectomies
2. Smaller sized breasts or willing for reduction of opposite side
3. When there is not enough skin in lower abdomen to take for a diep to form a good breast mound
4. When you are a smoker or have uncontrolled diabetes or major health issues.


These are just some guidelines....not the exacts...will have to decide along with your surgeon.

As far as removing the opp breast and getting both reconstructed, yes it is an option which will give better match as to the look of both breasts. If you have a strong family history and are BRCA positive then it is better to go for opp mastectomy and bilateral reconstruction.

Either way with unilateral reconstructions the other breast needs to be operated on usually in the form of a reduction. Sagging because of the weight of implants should not be too much of an issue since the implants are under the muscle and hence supoorted, but the normal breast will continue to sag.

I have tried to give you a brief overview of your options...the best decision will be made by you discussing with your surgeon.

Hope I have been able to help you make a decision.

Please keep me posted on your progress and all the best for your surgery.

Dr.Surindher
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Surindher

Cosmetic & Plastic Surgeon

Practicing since :1993

Answered : 69 Questions

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Had mastectomy of right breast. Would it be better to have the left breast removed and both breasts reconstructed with the implants?

Brief Answer:
hello, thank you for your query

Detailed Answer:
Your reconstructive options will depend on the status of the other breast and the desired size of the unaffected breast.

The breast can be reconstructed using a DIEP flap or a Lat.Dorsi flap with an implant. There are a few factors which help us decide....

DIEP:
1. When you have good enough skin in the abdomen for reconstructing the whole breast
2. If the breast size (opp side ) is big
3. If you dont want implants
4. The whole breast tissue and skin is removed.

LAT.DORSI:
1. In skin conserving mastectomies /lumpectomies
2. Smaller sized breasts or willing for reduction of opposite side
3. When there is not enough skin in lower abdomen to take for a diep to form a good breast mound
4. When you are a smoker or have uncontrolled diabetes or major health issues.


These are just some guidelines....not the exacts...will have to decide along with your surgeon.

As far as removing the opp breast and getting both reconstructed, yes it is an option which will give better match as to the look of both breasts. If you have a strong family history and are BRCA positive then it is better to go for opp mastectomy and bilateral reconstruction.

Either way with unilateral reconstructions the other breast needs to be operated on usually in the form of a reduction. Sagging because of the weight of implants should not be too much of an issue since the implants are under the muscle and hence supoorted, but the normal breast will continue to sag.

I have tried to give you a brief overview of your options...the best decision will be made by you discussing with your surgeon.

Hope I have been able to help you make a decision.

Please keep me posted on your progress and all the best for your surgery.

Dr.Surindher
WWW.WWWW.WW