Implant Based Breast Reconstruction

The majority of patients who undergo breast reconstruction following mastectomy do so through the use of breast implants. This technique for breast reconstruction has been the preferred procedure used for decades and has remained a reliable option for many. Typically performed in multiple surgeries this method of breast reconstruction can deliver reliable, long lasting results for many patients.

The first surgery, which is usually performed at the time of mastectomy and coordinated with the breast oncologic surgeon, involves the placement of a tissue expander. This device is similar to a water balloon and allows the surgeon to customize the reconstructive results by expanding the available skin following surgery to the desired size of the patient based on her underlying body type. In the majority of patients the expander is placed below the pectoralis major muscle at its top part and covered with a biologic material known as an acellular dermal matrix along its bottom part. Over the next 2-3 months the expander is gradually inflated in the surgeons office by placing a needle through the skin and into the device (most patients are numb in the breast skin so this is not typically uncomfortable). Once the desired size, or limit of possible inflation is reached the expander is left in place for a minimum of 1 month, after which time the patient is ready to have the exchange procedure.

Where the expander is inflated using saline the final implant is typically composed of silicone gel. The difference in shape and texture between these two devices is quite obvious and confers a much more natural shape and feel. Advances in implant technology are being realized almost daily and have led to better and more natural reconstructive results in recent years. The exchange procedure for silicone implants is almost always performed on an outpatient basis with minimal recovery as compared to the initial surgery.

Following the exchange to silicone patients may notice areas of irregularity or imperfection in their reconstructed breast. This is typically a result of attempting to fully reconstruct the body’s tissues using a standard device that will be different from the unique anatomy inherent to each and every person. These imperfections can be improved and possibly eliminated using additional techniques. Fat grafting is an exciting and new technique for attaining this goal and is the preferred procedure used by our surgeons.

Go to top