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Breast cancer can be treated with mastectomy. Often when a woman has breast cancer, she would like to proceed with a bilateral mastectomy, which is the removal of both breasts. Bilateral mastectomy can be done if cancer is in both breasts, or, if the patient would like to remove the other breast prophylactically. 

In a patient with ptotic breast, it is challenging to raise the nipple areola complex at the time of the mastectomy. Patients may present with a pseudoptosis which is defined as the presence of breast and skin beneath the level of the inframammary fold despite the nipple areola complex being above the level of the fold. 

The photograph demonstrates before and after bilateral mastectomy for breast cancer and removal of implants and placement of smaller implants. In the before photograph the patient has a significant amount of tissue below the level of the fold despite the nipple areola complex being above the level of the fold. Often at the time of the mastectomy, patients would like to decrease the size of theie breasts to smaller breasts.