I had a skin saving mastectomy. Because I had Brca 2 in the left side I was not able to keep the nipple. I did have an expander put in and 9 months later I had my other breast removed with implants. I was not big breasted, so the skin saving is right. It is a personal choice. Your breast surgeon hopefully has plastic surgeon they work with as i did and it made this process smooth. I will note you can find more information on this site under breast reconstruction. There are choices. I have read dozens of women who share they went flat.
Some have said the extra surgery was not worth it. I did have 2 surgeries, but overall it healed well and i have no complaints. These "barbie boobs" will be with me for 10 years at least. Keep us posted. It will help others. I think a moderator will also post with good links soon.