Direct to implant brca 1 positive

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Confused123
Confused123 Member Posts: 1
edited June 2014 in Breast Reconstruction

hi please need your help.. I'm brca 1 positive and opting for direct to implant surgery I think..was wondering who may have had it... I will mot be able to spare nipple as they are sagging low and unless I did a reduction first they can't keep it?? Help would love to know your experience and thoughts.. R u happy with it or would u do the diep instead.. I am doing a bilateral mastectomy for prophylactic reasons.

Thanks so much

Janice

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  • Moderators
    Moderators Member Posts: 25,912
    edited June 2014

    Hi Janice, welcome to the community.

    Just to let you know there is a June surgery sisters thread that is quite active if you would like to check it out in addition to this thread. 

    Sending you kind thoughts and hugs,

    from The Mods

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  • DiveCat
    DiveCat Member Posts: 968
    edited June 2014

    Hi Janice, 

    I had a prophylactic bilateral mastectomy with direct to implant in April.  I was able to keep my nipples as I did not have significant ptosis. 

    The problem with keeping the nipple if you have significant ptosis (this means sagging/droop below the IMF)
    is that your risks of tissue/nipple necrosis goes up, and your nipple
    placement might get very wonky as well. They can do some very amazing nipple
    reconstruction and/or 3D tattoos these days as well. I do know there are surgeons who will do a two-step process of doing a breast reduction or lift a few weeks or months before the mastectomy/reconstruction surgery if there is ptosis or extremely large breasts and a desire to keep the nipples. However, and hopefully someone else can clarify as I am not in the US, but insurance companies may not cover the first surgery.  And of course, many don't want to add on more surgeries.

    I am very, very happy I went direct to implant but to be honest DIEP was never even a consideration for me, not only due to my body not having much extra tissue but I was not interested in that surgery based on experiences of other family members, the increased recovery time, increased scarring/surgery sites, and potential complications. So for me it came down to implants, be it by tissue expanders or direct to implant. Some however are very, very happy with DIEP and there are some very busy DIEP threads around if you are interested in this surgery! Try the DIEP 2014 thread for example :)

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