Implant Reconstruction

For women who choose implant reconstruction, this usually involves multiples stages. Reconstruction begins at the time of mastectomy with tissue expanders placed on the chest wall beneath the skin and muscle. The expander is filled with saline (salt water) every two to three weeks in the office under local anesthesia, until the breast reaches the desired size. The patient then returns to the operating room for an outpatient procedure to remove the tissue expander and place a permanent implant. In some cases, specifically in women with a smaller breast size, a one-stage implant reconstruction may be possible with placement of a permanent implant at the time of mastectomy. Your surgical team with work with you to make the best decision to optimize your outcome.

Implants have undergone several modifications since their introduction in the 1960s. Improvements in the outer shell and fillers have made them safer and have given them a more natural look and feel. There are many types of implants available. All implants have a silicone shell, and some are filled with silicone gel and others with saline. They are equally safe, and your reconstructive surgeon can help you determine which implant is ideal for you.

The benefit of implant-based breast reconstruction is that it involves a shorter operation, shorter recovery, and it limits the operative field to the chest. It does have its limitations. Since the implant is a foreign body, it can potentially be felt and seen beneath the skin of the breast. It can also become infected, which would potentially require removal of the implant. Excessive scar tissue (capsular contraction) can also form around the implants causing them to become firm, change shape/position, and be tender. Severe capsular contraction (Baker Grade 3 and 4) may require revisional surgery. Finally, implants have the potential to rupture, and may need to be replaced over a patient’s lifetime.