Nipple-Sparing Masectomy with Prepectoral Implants

I had it done. You need to have relatively small breasts for it to work; otherwise the skin envelope can't regrow it's blood supply fast enough and some of the skin will die off. There is a thread of women who had pre-pec implants. Some were direct to implant (like me) and some had TEs first.

https://community.breastcancer.org/forum/44/topics/835911?page=68#idx_2022

I wanted direct to implant so I would be done after just one surgery but it didn't work out that way. The implants my PS put in looked horrible, so I had them replaced. In the meantime, I also had radiation, so I had to wait for six months after finishing rads to get them replaced. By then I had capsular contracture on the radiation side, so I would have been having more surgery anyway.

There is a decent chance of losing the nipple, especially with direct to implant. TEs are a little more forgiving; they give your skin a chance to regrow blood supply before stretching it over an implant. I still have both of my nipples, but the radiation side nipple is dark and a little shrunken, while the other one got much more pale after the BMX. I don't know if the dark shrunken one will go back to the way it was; my RO says it will but my PS says it won't. We'll see who's right.

I was going to have it, but they were only saving one of my nipples and I decided to ditch both nipples so they match. I ended up with skin sparing only (pre-pec).

Good luck with your surgery!