Nipple sparing or no on larger breasts with some sagging?

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9lives70
9lives70 Member Posts: 127
edited February 2017 in Breast Reconstruction

as I think about options for my upcoming breast reconstruction I'm wondering if it's worth the trouble to try to save my nipples. I currently have size DD breasts with implants from a prior augmentation that are now a bit saggy ( docs would classify as " level 2 ptosis")

From my conversations with various surgeons I've learned reconstructing larger breasts is a more complicated job and getting the nipples right and in the right position seems iffy. I also don't like the looks of many of the reconstructed nipples I've seen I'm thinking of just going to Vinnie for some nice tattoos and hoping to simplify things by not trying to keep my nipples.

I'm also planning on doing Implant based reconstruction since I've had implants and no problems with them. initially my big dream was to go with the direct implant procedure however I've learned that only really turns out well with smaller sized breasts and the pictures I've seen seem to illustrate that as well… So looks like it will be the expander route for me.

I'd love to hear the experiences of any of the larger breasted ladies out there... what you chose ( nipple sparing or not )and why and how things turned out for you :-) any regrets? Anything you do differently?

I am also fine with going a size smaller I would like to end up with perkier looking breasts and corrected nipple placement even if it's with tattoos :-)

Thanks for sharing your thoughts/experiences.


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Comments

  • OrcaPorkka
    OrcaPorkka Member Posts: 61
    edited January 2017

    I chose non-nipple sparing for the same reasons. My surgeon was not able to guarantee that the nipples would a. Heal b.Be symmetrical c. Have clean margins for one of the masses.

    So I had bilateral non nipple sparing, after 34 DD saggy boobs. My reconstruction has gone well (had some pocket revision because the right side pocket was too big) and I am pleased with their appearance even without the tattoo I eventually plan on.



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  • muska
    muska Member Posts: 1,195
    edited January 2017

    I was 36DDD when I was diagnosed, had nipple sparing BMX and am 36C now. The nipples are great, absolutely normal. I highly recommend this surgery if is medically appropriate in your case

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  • farmerlucy
    farmerlucy Member Posts: 3,985
    edited January 2017

    I was a C pre mx, and had a similar size implant. I asked about areola sparing, and having the nipple created from that. My PS said she was doing a lift and the nipples would be in the wrong place, though I got the sense that she doesn't like doing it anyway. So no nipple sparing for me. I went to Baltimore the year after my exchange for 3D tattoos from Vinnie Myer. Best thing about this whole mess. I rarely think about my new nips not being real. You have to touch the tattoo to even know it. They are amazing. Plus no bra - ever!

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  • Keiki
    Keiki Member Posts: 51
    edited January 2017
    9lives70

    I had nipple sparing BMX with TE and round implants. I was 34 C-D, now 34 DDD. I wanted to have immediate but you know the answers. Plus, I am 67, have delicate skin and had huge hematoma from my biopsy that I think alarmed the PS. I had some problems keeping the nips. One has minor scarring and they are not perfectly even. But I would do the same over again. However, I wanted to be smaller and both PS I consulted never told me a reduction would relocate the nips. When I went in for exchange I was expecting 580 Inspiras, got 750. Not what I wanted but happy to be complete. PS said nothing smaller looked good, too much skin. You may have same issues.

    Muska, tell us how you got smaller and good nip alignment, etc. Lucky you!

    Nipple alignment is an issue. My surgeon using a technique with Duoderm to position nips and preserve skin in better condition. I have photos on the forum if you have access.

    I'm 6 weeks post exchange and my best nip became perky just yesterday. They were flat and still numb.

    Saving nips does have challenges. I was prepared to lose them if margins close. You are smart addressing this now, I didn't know the questions to ask.

    Good luck with your surgery.

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  • muska
    muska Member Posts: 1,195
    edited January 2017

    Hi Ladies, I had large breasts and was size 36 DDD when I was diagnosed. Two tiny tumors rather deep in the breast. My breast surgeon who does a lot of nipple sparing procedures told me she would do it on me if nipple biopsy done during surgery shows no cancer cells near nipple. I wanted to have smaller breasts after reconstruction, however my plastic surgeon told me she wouldn't make me less than cup C because nipples would be misplaced or would have to be moved around if I were to be smaller than C. The incision was under the breasts and they didn't move the nipples, so the nipples look natural. I have 500ml implants. On the right breast where the IDC was, the areola is slightly discolored compared to the other one but this is hardly noticeable. Also, I had radiation on the right side which resulted in the right breast being a bit perkier than the left, but otherwise everything looks quite well. If it weren't for the radiation I would say everything looks great.

    The question was about the nipple sparing procedure. My impression is, it produces great results if done by an experienced surgeon on an appropriate candidate.

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  • Mominator
    Mominator Member Posts: 1,575
    edited February 2017

    Hello 9lives and friends,

    I had huge, ptotic breasts, my nipples were hanging lower than the inframammary fold. At my heaviest weight, I stuffed my breasts into 38 DD. After losing 50 pounds, I was down to 36 D or DD (depended on brand), but still ptotic. Right breast was at least a cup bigger and hung lower than left breast.

    BS and PS both said I was a candidate for nipple-sparing BMX. Both surgeons are very experienced in nipple-sparing techniques. PS told ("warned") me that I would be smaller than pre-BMX. I said thank you very much.

    I had nipple-sparing prophylactic BMX with TEs. A large crescent of skin above the nipples was removed from each breast. The nipples and remainder of breast skin were brought up. More tissue was removed from right breast than left. I have Natrelle 410 Style FX Anatomically shaped implants. Left is 450cc and Right is 495. Last week was 1 year since exchange surgery.  

    I am now 36 B/C. I am very happy. My breasts are perkier, sisters but not twins. I look very good in clothes and even bathing suits. Left looks a little looks larger in volume than the right. Right has settled a little lower. The nipples look very good, not exactly even although that's more to settling and volume. My breasts look more similar to each other now than pre-BMX.

    I have no regrets and I would do it again. I have achieved my goal: reducing my risk of breast cancer.

    I haven't posted my pictures on the forum, it never occurred to me. But I could send them to you.

    Best wishes to you.

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  • OG56
    OG56 Member Posts: 897
    edited February 2017

    I thought I was going to have nipple sparing and skin sparing double mastectomy . However my breast surgeon let me know that on the cancer side it might not work. I was told that my incisions would be made under the inframammary fold that is not what happened my incisions are under my arms and go almost to my back and then halfway across each breast. it actually looks like they did nipple sparing on my right side although he says he didn't I guess it's just phantom feeling in that side that I occasionally have . I must say my breast surgeon and my plastic surgeon are very renowned in my town my breast surgeon did my first cancer surgery I was very happy with him but that is not true with what's going on now I don't know exactly how they're going to fix them I have 800 mL expanders in and I would say I'm a B or a small C.because I'm very broad-based I was a 40 double D before surgery although I have fairly perky breasts and was a level one Pitosis, this is my story and I'm sticking to it . I had surgery on November 16 and I just got my mammoprint results back last week and found out I'm high risk for recurrence and liminal B so I start chemo next Tuesday but luckily I can do it with a pic line and not a port and it won't mess with my expanders . Have a great weekend everybody 🐦

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  • debiann
    debiann Member Posts: 1,200
    edited February 2017

    My BS advised not keeping the nipple on the cancer side, so I had them take both so they would look the same.

    My PS did areola and nipple recon and it looks good.

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