Implant-Based Reconstruction

As a woman, having your breasts removed is not any easy decision.  Fortunately, there are many options for breast reconstruction to help reestablish or maintain a sense of wholeness, femininity and sexuality.  The most straightforward solution is implants alone.  This procedure is appropriate for patients with medical issues that prevent them from undergoing complex surgery.  Implant reconstruction is typically completed in two phases.  The first phase is performed at the same time as the mastectomy and includes the placement of a tissue expander in the breast area underneath the skin and chest muscle.  During the next 8-10 weeks, patients must visit our office on a weekly or biweekly basis to have the tissue expander filled until the desired size is reached.   The second phase involves removing the expander and replacing it with a permanent implant.  In certain cases, patients may not require expansion process and have the implants placed in the first phase.

Patients should understand that breast implant reconstruction is not the same as cosmetic breast augmentation.  With cosmetic augmentation, the implant is placed under normal breast tissue or under the tissue and muscle.  This results in a more natural feel and shape.  With reconstruction, only skin and muscle remain.  The expander and/or implant are often placed under the pectoralis muscle to protect the skin.  Because this muscle is unlikely to completely cover the expander or implant, a sheet of collagen is used to conceal the lower part of the implant to improve the cushioning of tissue over this area.  Even when implants are placed at the time of mastectomy, touch-up procedures are often indicated. Implants should be replaced every 10 years, so additional surgeries may be required during your lifetime. Infection, scarring, rupture, and firmness of the implant may occur over time.