Serving Patients in Jacksonville, Florida
Implant Based Breast Reconstruction
The first stage of most implant based breast reconstruction begins with the placement of a tissue expander under the pectoralis major muscle. A tissue expander is an implant that has a self-sealing port that can be gradually filled over time to help stretch the skin and muscle. If the tissue expander is placed in the setting of immediate breast reconstruction at the time of mastectomy, plastic surgeons will often use biologic mesh to help create better expander coverage and positioning.
Once the skin heals over the first 1-2 weeks, the expansion process will begin. Your tissue expander will be filled with approximately 60 ml of saline every 1-2 weeks or according to your chemotherapy schedule. Some patients wish to go slightly faster and have their expanders filled with more volume. The goal with each expansion is to stretch the skin and muscle, but to do it without causing significant discomfort for the patient.
The expansion process generally lasts 2-3 months depending on what cup size each patient desires. Once you are at a volume that you think is appropriate for you, we generally recommend 1-2 extra fills since you will loose some projection when changing from the tissue expander to your permanent implant. Then during the second stage of your breast reconstruction, an outpatient procedure is performed where the tissue expander is removed and either a permanent silicone gel or saline implant is inserted. The second stage is usually performed 2-3 months after the first operation unless chemotherapy or radiation therapy is required. Most patients go on to complete their nipple-areola reconstruction.
In some cases an implant is placed in an immediate setting to reconstruct the breast in one stage breast, thereby, eliminating the need for tissue expansion. Patients must meet a number of criteria to be candidates for this procedure.
Advantages of Implant Based Breast Reconstruction
- Provides an upper-breast fullness for a more youthful look to the breast
- The recovery from implant placement is generally faster than flap reconstruction methods
- There are no additional scars on the body.
- It can be matched on the opposite breast.
- The extra volume can help correct ptosis (loose skin) of the breast.
Disadvantages of Implant Based Breast Reconstruction
- An implant is a foreign body in the breast tissue. There is an increased risk for infection around the implant.
- Less natural breast shape
- Wrinkling or rippling of the implants may occur
- Breast tissue may form capsule around the implant causing the breast to become firm and sometimes painful
- Expander placement does require 2 stages for breast reconstruction and several visits to the office to fill the expander.
Desai Center of Plastic & Reconstructive Surgery
14540 Old St. Augustine Road Suite #2391 | Jacksonville, Florida 32258