Armchair Expert with Dax Shepard

Podbit · Armchair Expert with Dax Shepard

Jackie Tohn Returns

Explore episode Jul 13, 2026
Health & Fitness
Preventative Mastectomy: Straight-to-Implant vs. Expanders

Jackie Tohn Returns · Jul 13, 2026 Health & Fitness

When a woman gets a preventative double mastectomy, she chooses between two surgical paths: straight-to-implant (done while still under anesthesia) or expanders first (two separate procedures). Jackie went straight-to-implant with Dr. Kasliff and Dr. Richardson at the Bedford Breast Center, waking up with the final result. Her surgeons even propped her up mid-surgery to assess the size.

Where this was said

The Surgery: Straight-to-Implant, Drag Queens, and Dr. Kasliff

At 31:18 · chapter starts 30:10

Jackie describes the key surgical choice BRCA-positive women face: straight-to-implant reconstruction done in a single operation, or tissue expanders placed first and replaced later. She chose the former at the Bedford Breast Center under Dr. Kasliff (former head of plastics at Cedars) and Dr. Richardson. To find reference images for her desired result, she DM'd drag queen and trans woman Bosco from RuPaul's Drag Race, who immediately sent her an implant card photo — an act of solidarity Jackie found deeply moving. Her surgeons propped her up on the operating table to assess the size visually, ultimately going slightly smaller than planned. She woke up to the news that they'd sized down — a choice she's grateful for, contrasting with friends who woke up larger than agreed, especially with male doctors.

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