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CassilethMD2789 karma

Absolutely... recently one of my young breast cancer patient got married. One year prior, she was diagnosed with breast cancer, and initially she was told she would have long scars, no nipples, and would be lucky to look good in clothes at all. We of course did a nipple sparing mastectomy and she has no visible scars. She sent our office her wedding photos of her in a strapless dress? How fabulous to allow this young woman to move on with her life, and sorry to be superficial, to be HOT after having breast cancer!!!!

CassilethMD2299 karma

The implants feel pretty good. My favorite thing is when the husbands/boyfriends check the implant out they always close their eyes. Hilarious.

CassilethMD1749 karma

Love your question. I have a very different philosophy than pretty much everybody else. I think that breasts should always have the same amount of fatty tissue and the same amount of implant. II have three tools, reduction (removes breast tissue), implants, and fat grafting (adds fatty natural tissue). So, if she would like a large C let's say, reduce the DD down and augment both sides with the same implant. Usually need a small lift on the DD side. Or if she wants a DD on both, you can fat graft the C side, possibly reduce the DD side, and augment them both? Get it? It's a little complex, but at the end of any procedure the breast should be the same, essentially. Never augment asymmetrically as they always get exaggerated over time and is inherently the wring answer.

CassilethMD1146 karma

This completely sucks. I've had good luck with these just resmoothing the skin with a combination lipo and excision. You've got to get the fatty spots out as it weighs down the skin and makes it wrinkle and fold weird, and sometimes I fat graft the thin spots as well as areas overresected can stick to the muscle and that looks weird. It's a bad problem, but it is fixable, and you may get your insurance to pay for it especially is you have a real deformity.

CassilethMD694 karma

This is going to sound awful, but I so so love bad problems from prior surgery. It's like a great opportunity to really do some great things. Last week I had stacked implants, capsular contractures with the ones on top of the muscle, the ones under the muscle had fallen into the armpits, ruptured silicone, and the nipples put too high looking straight up at the top of the boob. When I removed the capsule it was full of free silicone and old black ooze that I think must be from old congealed blood from the last surgery. So much fun to fix that... !!! I know I'm weird!