I had a single mastectomy with nipple & skin sparing reconstruction with a tissue expander. This was on 10/18/23. My surgeon did a biopsy of the back of my areola in the OR and she checked to make sure she had clean margins by doing some kind of pathology test on the tumor in the OR. Also xrayed the tumor to make sure she had all the clips that were placed during the biopsy. The blood supply for my nipple comes from the skin around it. I was prepared to lose my nipple but it was nice not to. Many people have mastectomy with direct implants and are happy. It depends on your cancer situation and your personal preference. I think the best u can do is find good doctors and surgeons and ask lots of questions.

I would wait for the 10-20 year data unless you want to be part of the “studies”. There just isn’t enough information. I wish I would have waited for the 20 year Data on the “new improved” implants. I got my first implants in 2003 (saline). So 15 years ago - and all the long term information/ studies and risks are just starting to trickle out. Then the new silicone was improved in 2005. I waited til 2011 to switch them- so 6 years - by 2012 - I was deathly ill and had no idea why. Figured it out last year 2017 - went to have them removed - I didn’t want the cancer they were found to cause now and couldn’t get them out fast enough and that’s when/ how I discovered I had cancer ☹️ I was too late 👎🏼 And so here I am. That’s was 14 years - but the 5 year data looked fabulous and safe 😳. Good luck. None of these decisions are easy and none of the choices are appealing. I did have a friend last year diagnosed at 39 - she did immediate reconstruction direct to implant - skin sparing etc ... they didn’t get clean margins because they were too concerned keeping all the skin and didnt want to compromise the cosmetic result - so they didnt go back and get clean margins - they said “oh just a few rounds of radiation should get that...”. Which she was so scared of that she never did the radiation - soooooo.... not sure what’s going to become her situation at this point. 😳 I personally didn’t want any chance of chemo or radiation. I was very surgically aggressive and like zia - removed the nipples and everything. Good luck to you ❤️❤️❤️

Hi Mel! I was not a candidate for direct implant. They took so much tissue that I was I bit concave. Since my sister had bc at 37, I already had my mind made up to “take it all,” if I was ever diagnosed. I opted to have them take my nipples, as it lowered my chances for reoccurrence. It’s no big deal to me, as I will get tattoos later, as did my sister and best friend. My doctor said our med school out here had been conducting research on nipple sparing. I have head of a few people getting an implant without reconstruction. Mine wasn’t bad at all. A few days ago, when I got the exchange, my doctor cleaned up my scar and now I just have a tiny thin line. Hope this helps. It’s a big decision, but just do what’s right for you! 😊

I also had skin sparing bilateral mastectomy and diep flap reconstruction in January. This surgery was about 6 weeks after i had completed 8 infusions of chemo. My bc was triple negative stage 1b and no lymph nodes were involved, but because i have BRCA1, nipple sparing was out of the question. i chose bilateral mastectomy so as to prevent in other breast. 6 months later this past July, i had revision surgery as well as both ovaries and fallopian tubes removed as a prevention measure as well because Drs told me i had 40-80% chance to develop ovarian cancer.
It’s been 3 months now and i’m finally getting my strength back and feeling myself. Still dealing with neuropathy from Taxol, but it’s getting some better. Also some days fatigue. But a positive attitude keeps me going, plus my faith and a supportive husband.
Next step… maybe nipple reconstruction and/or 3D tattoo… Anyone have experience?

I had the nipple saving surgery because I chose reconstruction using the expander first approach. I don’t recall being told it would increase the chance of recurrence. I happen to be a side sleeper so my implant has shifted. It could not be repositioned because the pocket is too tight. My plastic surgeon advised against another surgery until the 10 year mark. The nipple is ornamental only, but at least it looks more normal compared to the alternatives.