Breast Reconstruction with Breast Implant
Breast reconstruction is a procedure that has a positive physical effect, but the emotional impact is the most important. Very often, the loss of a breast is equivalent to losing a first-degree relative. Therefore, the decision to undergo reconstruction is an important step toward regaining femininity, as well as bodily and emotional integrity.
What is breast reconstruction and how is it done?
Breast reconstruction with a breast implant is the most commonly used procedure, a relatively simple reconstructive procedure for the patient in terms of recovery, yet complex for the surgeon.
You should know that the nipple and areola are reconstructed in a later stage. Most of the time, procedures to adjust the contralateral breast are needed: augmentation, reduction, or lift.
WHEN CAN BREAST RECONSTRUCTION BE PERFORMED?
- simultaneously with mastectomy
- secondary, after a period of time from the first surgery
Breast Reconstruction: Options and Risks
WHEN CAN RECONSTRUCTION BE DONE IN A SINGLE STAGE?
- when there is enough tissue to cover the implant, it is placed under the pectoral major muscle, and the skin is sutured directly.
- when there is enough remaining skin and soft tissue (fat and muscle)
WHEN IS DIRECT RECONSTRUCTION WITH A SILICONE PROSTHESIS/IMPLANT RECOMMENDED?
- for those who do NOT want reconstruction with flaps
- when there is sufficient skin remaining after mastectomy
- bilateral mastectomy
- small or medium breasts
- patients who agree to surgery for symmetrizing the healthy breast
CHOOSING THE IMPLANT
The implant choice is made together with the plastic surgeon. Round or anatomical cohesive gel (silicone) implants with a textured surface are used. When choosing an implant, the body shape and contralateral breast (which may need later symmetrization) are taken into consideration.
WHEN IS THE TISSUE EXPANDER OPTION USED, REPLACED LATER WITH AN IMPLANT?
When there is enough tissue but a risk of implant exposure exists, a tissue expander is used, which is later replaced with the permanent implant. The expander is placed in a “pocket” under the pectoral muscle, sutured completely, and gradually filled with saline. Inflation lasts 3-6 months, after which it is replaced in a new surgery with the breast implant.
It is very important to follow postoperative instructions to avoid the complications mentioned above. Recovery varies from person to person depending on age, health condition, etc.
WHEN IS BREAST IMPLANT RECONSTRUCTION CONTRAINDICATED?
Some situations contraindicate this reconstructive procedure:
- skin damaged by radiotherapy
- advanced disease
- obesity
- autoimmune diseases
- psychiatric conditions
WHAT COMPLICATIONS MAY OCCUR?
The main complications, though rare, are local:
- hematoma
- seroma
- infection
- wound dehiscence
- hypertrophic appearance
- implant rippling (wrinkled appearance). To improve this, a later session of autologous fat grafting is necessary.
BREAST RECONSTRUCTION SURGERY
- performed under general anesthesia
- implant is placed under the pectoral major muscle
- permanent volume and acceptable shape of the reconstructed breast are obtained
