Board-Certified Plastic Surgeons Serving Denver, Lone Tree, Colorado & Nationwide
For women with a BRCA1 or BRCA2 mutation or a strong family history of breast cancer, prophylactic mastectomy can significantly reduce lifetime risk. Along with lowering their risk, women often want clarity about reconstruction choices and what to expect after surgery.
At The Breast Center at Park Meadows Cosmetic Surgery in Lone Tree, Colorado, board-certified plastic and reconstructive surgeons Dr. Christopher G. Williams and Dr. Jeremy Z. Williams provide advanced expertise in prophylactic breast surgery planning and microsurgical reconstruction. Both completed extensive training at The Johns Hopkins Hospital, and together they offer state-of-the-art techniques, including the DIEP flap procedure, for women seeking high-level preventive breast care.
BRCA1 and BRCA2 Gene Mutations
BRCA1 and BRCA2 are human genes that belong to a class of genes known as tumor suppressors. In normal cells, BRCA1 and BRCA2 help ensure the stability of the cell’s genetic material (DNA) and help prevent uncontrolled cell growth. Mutations of these genes have been linked to the development of hereditary breast and ovarian cancer.
The names BRCA1 and BRCA2 stand for breast cancer susceptibility gene 1 and breast cancer susceptibility gene 2, respectively.
Breast Cancer Risk and BRCA Mutations
According to lifetime risk estimates, about 12% of women in the general population (120 out of 1,000) will develop breast cancer during their lives. In comparison, about 60% of women (600 out of 1,000) who inherit a harmful BRCA1 or BRCA2 mutation will develop breast cancer.
In other words, a woman who has inherited a harmful mutation in BRCA1 or BRCA2 is about five times more likely to develop breast cancer than a woman who does not have such a mutation.
Who Is at Higher Genetic Risk?
Women at increased risk of having a harmful BRCA1 or BRCA2 mutation often have strong family histories of breast cancer. These patterns include:
- Two first-degree relatives (mother, daughter, or sister) diagnosed with breast cancer, one of whom was diagnosed at age 50 or younger
- Three or more first-degree or second-degree (grandmother or aunt) relatives diagnosed with breast cancer, regardless of their age at diagnosis
- A combination of first- and second-degree relatives diagnosed with breast cancer and ovarian cancer (one cancer type per person)
- A first-degree relative with cancer diagnosed in both breasts (bilateral breast cancer)
- A combination of two or more first- or second-degree relatives diagnosed with ovarian cancer, regardless of age at diagnosis
- A first- or second-degree relative diagnosed with both breast and ovarian cancer, regardless of age at diagnosis
- Breast cancer diagnosed in a male relative
Risk-Reducing (Prophylactic) Mastectomy
For women who have been diagnosed with BRCA1 or BRCA2 gene mutations or women without gene mutations and a strong family history, prophylactic or risk-reducing mastectomies are often recommended. This is a unique population of women seeking breast reconstruction before they have developed breast cancer.
Breast reconstruction is provided by a woman’s insurance, as mandated by federal law, anytime a breast is removed either for active cancer or appropriate risk reduction.
Breast Reconstruction Options After Prophylactic Mastectomy
After a prophylactic mastectomy, women may choose to undergo breast reconstruction at the same time as their mastectomy (immediate reconstruction) or at a later date (delayed reconstruction). The right timing depends on personal preference, medical history, and overall treatment planning.
Reconstruction options generally include:
Implant-Based Reconstruction
This approach uses a saline or silicone implant to recreate breast shape. It may involve a staged process with a tissue expander before final implant placement.
Autologous (Flap) Reconstruction
This technique uses your own tissue, typically from the abdomen, to reconstruct the breast. Our surgeons perform advanced microsurgical reconstruction, including the DIEP flap procedure, which preserves abdominal muscle while restoring breast volume and contour.
Every reconstruction plan is tailored to the patient’s anatomy, risk profile, and personal goals.
Genetic Testing and Counseling
The choice to undergo testing to determine the presence of the BRCA 1 or BRCA 2 genes is best made within the counsel of a genetic counselor with specific experience in the field of breast cancer.
At The Breast Center, we are fortunate to have relationships with numerous genetic counselors throughout the state of Colorado and would be happy to provide this referral to patients seeking genetic testing.
Why Choose The Breast Center at Park Meadows Cosmetic Surgery for Prophylactic Mastectomy Reconstruction?
Prophylactic mastectomy requires careful coordination and surgical precision. Board-certified plastic and reconstructive surgeons Dr. Christopher G. Williams and Dr. Jeremy Z. Williams work closely with experienced general breast surgeons to ensure a seamless transition from mastectomy to reconstruction.Â
Both surgeons completed extensive plastic surgery training at The Johns Hopkins Hospital, one of the nation’s most respected institutions, and bring expertise in complex breast reconstruction to women in Denver and throughout Colorado. They perform advanced microsurgical techniques, including the DIEP flap procedure, offering women thoughtful surgical planning, technical expertise, and comprehensive reconstructive care following prophylactic mastectomy.
Frequently Asked Questions
Prophylactic mastectomy significantly lowers the risk of developing breast cancer, especially for women with a BRCA1 or BRCA2 mutation. Studies show risk reduction can be as high as 90–95%.
While no surgery can remove every breast cell and eliminate risk entirely, this procedure dramatically decreases the likelihood of developing breast cancer over a lifetime. Your exact level of risk reduction depends on your genetic profile and personal medical history.
Most women experience changes in breast and nipple sensation after mastectomy. Because breast tissue and many small sensory nerves are removed during surgery, numbness is common. Some sensation may gradually return over time, but it is often reduced compared to before surgery. The degree of sensation loss depends on the type of mastectomy performed and whether nerves can be preserved.
Recovery time varies based on the type of reconstruction performed. Implant-based reconstruction generally involves a shorter initial recovery, with many women resuming light activities within a few weeks. Autologous reconstruction, such as a DIEP flap, typically requires a longer recovery period due to the additional donor site surgery.
Most patients can expect several weeks of healing before returning to normal routines, with full recovery taking longer, depending on the procedure and individual healing.
As with any surgery, there are risks. These may include bleeding, infection, delayed wound healing, fluid collection, implant-related complications, or partial flap loss in tissue-based reconstruction. There is also the possibility of asymmetry or the need for revision procedures. Your surgeons will review your individual risk factors and discuss strategies used to promote optimal healing.
Yes. Reconstruction allows you to discuss desired breast size and shape with your surgeon. Some women choose to maintain their natural size, while others prefer to be slightly smaller or larger. The options available depend on your body type, the type of reconstruction selected, and surgical considerations.
Learn More About Genetic Screening
For more information about genetic screening and other breast cancer risk factors, please contact The Breast Center Park Meadows Surgery online or call 303-706-1100. We are pleased to serve patients from Denver and throughout Colorado from our office in Lone Tree, and we also welcome patients throughout the country.