Implant Breast Reconstruction

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What Is Implant base Breast Reconstruction?

Implant base breast reconstruction is the most popular technique currently used in breast reconstruction. It is popular because the reconstruction results are excellent and the patients may return to work much faster than autologous breast reconstruction. The drawbacks are that  it requires an implant and multiple surgeries. If a patient has radiation to the chest wall, implant base breast reconstruction will not be the best option due to higher rates of capsular contraction, implant exposure, and infection.

Implant base breast reconstruction usually requires two stages of surgery.

 

Stage 1 – Mastectomy and placement of tissue expander

In the first stage, your oncologic breast surgeon will perform the mastectomy and Dr. Goldberg will perform the reconstruction simultaneously. At this surgery, Dr. Goldberg will place a tissue expander along with the acellular dermal matrix (ADM) into the mastectomy pocket. The tissue expander, filled with salt water, is used as a spacer to keep the breast skin expanded and smooth. The ADM human dermal matrix is treated with radiation and detergent removing all cellular products, is placed inferior to the pectoralis muscle (chest muscle). It forms a pocket for a permanent implant at the second stage. Your body will eventually incorporate the ADM to become a part of your body. This stage is extremely important because it sets the foot print for a new breast. In the postoperative period, Dr. Goldberg will slowly inflate the tissue expander to stretch out the remaining breast skin in the office. This is performed weekly or biweekly. The tissue expander is then inflated to a desired volume.

Length of surgery –  2 hours per breast.

Length of hospital stay – 1 night

Time to recovery – 2 weeks -may return to light work or desk work at 2 weeks postop.

Drains – 1 drain per breast

 

Stage 2 – Removal of tissue expander and placement of permanent implants

The second stage surgery takes place approximately 3 months after the first surgery. At the second surgery, Dr. Goldberg removes the tissue expander and places a permanent implant into the breast. At the same time, Dr. Goldberg also performs fat grafting to the reconstructed breast to correct minor contour irregularity as well as improve the appearance of the breast.

Length of surgery – 2 hours each breast

Same day surgery – no overnight stay required

Time to recovery – 3-4 days. May return to work within one week.

Drains – 1 drain per breast.

 

Stage 3 – Nipple reconstruction 

Nipple reconstruction takes place at 3 months after stage 2 surgery. Dr. Goldberg considers this an essential part of breast reconstructions. It is the equivalent of putting a bow on a wrapped present. At this surgery, Dr. Goldberg will build a nipple using local tissue on the breast and she also may perform additional fat grafting to the reconstructed breast.

Length of surgery – 2 hours

Same day surgery – no overnight stay required

Time to recovery – 1 -2 days

No drain

 

 

 

 

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