Implant Based Breast Reconstruction

When treating breast cancer, your surgeon may completely remove the affected breast or remove the tumor as a lump along with a portion of healthy surrounding tissue. Breast reconstruction is surgery performed to restore the shape and size of the breast following cancer surgery.

Breast reconstruction can be performed in two ways:

Using implants to replace the breast tissue.

Replacing the breast tissue with tissue transplanted from your stomach, buttocks, back or thigh.

Breast implants are artificial shells filled with sterile saline or silicone gel which is surgically implanted to replace breast tissue. They vary in shape and texture and can be placed either under or over the chest muscles.

Overview.

Breast cancer usually begins in the lobules or milk ducts and can sometimes occur in the fatty and fibrous breast tissue. Breast cancer surgery involves the surgical removal of a tumor to prevent the spread of cancer to other parts of the body.

Indications.

Breast reconstruction may be performed after mastectomy or loss of breast tissue secondary to trauma or injury. In some cases it may also be performed to rectify a birth defect.

Your doctor may perform reconstruction either during breast cancer surgery or a few months after the procedure. Reconstruction can also be performed in a staged manner, partly during the initial surgery and then completed in a second surgery.

Surgical procedure.

If the procedure is performed during breast cancer surgery and you have sufficient tissue to cover the implant, your doctor will place the implant under your chest muscles after removal of the breast tissue.

If you have lost a significant amount of tissue or skin, your doctor will place a tissue expander between your chest muscles and skin. This will gradually be filled with saline over a period of weeks to stretch out the skin until it can accommodate an implant. Once the skin is stretched enough, the tissue expander is exchanged for the implant.

If you require radiation therapy, your doctor may recommend you receive it while the tissue expander is in place. The final implant is then placed after the completion of therapy.

Post-Operative Care.

Following surgery, your doctor will give you instructions on caring for your surgical wound, drains and dressings. You will also be taught specific exercises to prevent stiffness and scar tissue formation. It usually takes six weeks to recover from breast implant surgery performed along with mastectomy or lumpectomy. For delayed implant surgery, the tissue expander is exchanged for the final implant during an outpatient procedure performed under general anesthesia and requires a 2-week recovery period.

Advantages & Disadvantages.

Implant based reconstruction is less complex and does not involve removal of donor tissue from any other part of your body such as in a flap reconstruction.

However, implants can wear out and develop complications over time requiring repeat surgery. It is also not a good option if you require radiation therapy.

Risks and complications.

As with any surgery, implant based breast reconstruction may be associated with certain complications such as:

Scar tissue formation.

Capsular contracture.

Tissue break down.

Shifting or rupture of the implant.

Breast reconstruction has been found to greatly enhance the patient’s self-image and quality-of-life following cancer surgery. Implant-based breast reconstruction has several advantages and can often be performed during breast cancer surgery without the need for another operation.