Q: Dr. Eppley, I am 29 years old woman, married, and haven’t any children with a positive family history for breast cancer in my mother and sister. I had two lesions removed from my left breast (intraductal carcinoma) with clear margins recently. The surgeon suggested for removal both breasts and replacement prosthesis. But there is a limited size of prosthesis in Iran and the plastic surgeon said that my breast size is too small for the smallest size of prosthesis that there is in Iran. In your opinion, is there a solution for this problem? How much would this type of surgery cost in your country? Is there any charitable surgery in your country for this type of surgery?
A: It appears that with your family history and recent breast lesion pathology that you would benefit from bilateral prophylactic mastectomies with immediate breast implant reconstruction. I am unclear as to the statement that ‘your current breast size is too small for even the smallest breast implant’. That makes no sense to me nor would I believe that is true. Breast implants come as small as less than 200cc so there is a size of an implant that would fit you. Your solution is a straightforward subcutaneous mastectomy with immediate implant placement. I know of no charitable organization that would provide free care for this standard prophylactic breast cancer surgery for foreign visitors. I would be happy to provide you a fee for what this costs in my center. In the interim, it would also be helpful to see what your current breast status/size is with a few pictures if that is possible.
Dr. Barry Eppley