Reconstruction with Breast Implants
A common form of breast reconstruction utilizes an implant to recreate your breast mound. This procedure takes about 60-90 minutes and may be performed immediately through your mastectomy incision or delayed through a pre-existing scar.
- This surgery works well for women whose opposite breast is modest size (A or B cup) and has minimal laxity (looseness) or drooping (ptosis).
- This surgery does not work as well for women who have larger breasts (C or D cup), a very lax breast, or who are substantially overweight.
- A history of previous radiation to the breast (i.e., a previous lumpectomy followed by radiation) makes this surgery difficult as the irradiated skin and muscle may not allow adequate expansion.
First Stage procedure is done following the mastectomy.
- A pocket is created behind the pectoralis muscle and a temporary implant called a tissue expander is inserted.
- The expander is similar to the final implant; however it contains a valve, which allows fluid to be added after surgery.
- Beginning about two to three weeks after surgery, the expander is gradually filled with fluid, stretching your skin and muscle, creating room for the final implant.
- The expansion process requires weekly office visits for a few weeks.
- The expander will be slightly over-inflated to compensate for normal skin shrinkage after your final implant is placed.
Second Stage procedure is performed two to three months after final inflation, if no additional therapy is required. During this outpatient procedure, the expander is removed and a final implant is placed.
- The final implant is made of a thin silicone shell and filled with either saline or silicone gel.
- The choice of implant is made by you, prior to your procedure.
- Implants are not guaranteed forever and have a limited lifespan of uncertain length. An implant may therefore need to be replaced during your lifetime.
In some selected cases, the expansion process may be omitted and an implant placed at the time of the mastectomy as a one-step procedure.
- This procedure involves inserting the final implant, rather than a tissue expander, under the chest muscle at the time of the mastectomy.
- This avoids the need for the expansion process after the initial procedure and may avoid the need for a second procedure. The ability to offer this procedure depends on your breast size and the amount of skin remaining after the mastectomy.
Summary of Reconstruction Using Breast Implants
||2 or 3 surgeries
||First Stage: Usually 1-2 days
Second Stage: Outpatient
|Need for Multiple Office Visits
||Yes (for expansion)
||Mastectomy scar only
|Shape and Consistency
||No natural sag; flat across front; may be firm
||More changes usually needed to achieve a match in a bra
||Altered in surgical areas
||Breast hardening with shape change; skin ripples, infection; rupture
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