Breast reconstruction after a mastectomy is more frequently performed using implants rather than flap reconstruction methods. Implant breast reconstruction tends to be a less-invasive procedure, and often begins with the placement of a tissue expander in the breast area. This tissue expander is used to stretch the skin and make room for an implant of the patient’s choice. Breast reconstruction with implants can begin at the same time as mastectomy, or can be scheduled for a later date.
Breast Implants v. Flap reconstruction
Each method of breast reconstructive surgery has its own benefits and risks. Reconstructive surgery using a tissue expander and implant is often appealing, however, because it requires less surgery. Whereas flap reconstruction creates two surgical sites, breast reconstruction using implants is done solely in the breast area. This results in fewer scars, and fewer risks of infection. However, it should be noted that breast reconstruction using implants often does not yield as realistic-looking results as tissue-based reconstruction methods.
Breast Reconstruction Using a Tissue Expander
Following a mastectomy, many women do not have adequate skin in the breast area to support in implant. In this case, a surgeon will place a tissue expander to gradually stretch the skin and make room for an implant. The surgeon will insert a balloon-like tissue expander under the chest muscle. At weekly intervals, usually beginning two weeks after the mastectomy, the surgeon injects saline solution into the tissue expander through a small valve located just below the surface of the patient’s skin. Once the tissue expander has sufficiently stretched, the surgeon replaces it with a breast implant. Adjustments to the tissue expander, and placement of the final implant, typically take about six to eight weeks.
Immediate Implant Breast Reconstruction
In some cases of breast reconstruction, using a tissue expander is not necessary. If the patient has enough skin to adequately cover the implant, it can be placed at the time of mastectomy or at a later date. For patients who qualify, this technique is more convenient than other reconstruction procedures since it does not require multiple appointments.
Whether you are considering breast reconstruction with implants during or after mastectomy surgery, you will want to discuss with your doctor whether the use of a tissue expander will be necessary. In addition, you can discuss your options for further reconstruction including re-creation of the nipple and areola.
Risks of Implant Reconstruction
Although implant breast reconstruction is popular, there are some things that all patients should consider prior to surgery.
- Implants typically last about 10 years, and many need to be replaced or enhanced
- Scar tissue can develop around the implant- resulting in a less natural-looking breast
- Natural breast cannot be exactly replicated
Many Patients Want to Know …
Am I a Candidate for Implant Breast Reconstruction?
Breast reconstruction using a tissue expander and breast implants is often recommended for women who are particularly thin and therefore do not have enough excess skin to support tissue-based reconstruction. It is also a viable option for older women since it is less invasive, and requires less recovery time. It is important to speak to your physician to learn if your specific condition makes you a candidate for implant breast reconstruction.
Contact a Plastic Surgeon
Contact a plastic surgeon to find out if breast reconstruction is right for you.