Implant reconstruction or tissue expander reconstruction is most commonly a two-step procedure.
- At the time of mastectomy, surgeons will insert a tissue expander, which is a balloon like device, underneath the skin and muscles of the chest wall. At Albany Med, we often use a piece of processed cadaveric skin, which helps improve the shape of the breast and decreases the time to target expansion. At the time of surgery, the surgeon will inject a small amount of saline into the expander through a valve in the device; however, you will have very little projection.
- While you heal from the mastectomy, you will begin the process of tissue expansion. This usually begins two weeks after surgery. The patient will have to come to the office on a weekly or bi-weekly basis and their surgeon will insert a small needle into the valve in the tissue expander and inject a small amount of saline or salt water. This is gradually done to allow the chest muscle and skin to stretch to accommodate the appropriate sized implant. Once your tissue expanders have the correct amount of saline in them, you will need to wait at least three months before the second stage of surgery. If you need to undergo chemotherapy, the next stage is delayed until chemotherapy is completed.
- In the second stage, surgeons remove the tissue expander and place the implants. This can be either silicone (gel) or saline filled implants. Both types of implants are made of a silicone shell; the difference is what the implants are filled with. Both are safe however most people prefer the silicone implants. Your plastic surgeon will help you to make the choice of permanent implants that are best for you. This surgery will not require an overnight stay in the hospital and recovery takes about two weeks. The whole process from the time of the mastectomy to when the final implants are placed can take anywhere from three to six months.
Implant reconstruction recovery time
Stage 1: A patient is usually in the hospital one to two days following the procedure and recovery time is about four weeks. Patients can expect their first tissue expansion two weeks after the initial operation.
Stage 2: This surgery takes place about three months after stage one is complete. This procedure does not require an overnight stay in the hospital and recovery takes about two weeks.
Advantages of Implant Reconstruction
- Decreased surgery and recovery time
- Fewer scars
- Satisfactory shape in clothing
Disadvantages of Implant Reconstruction
- Need frequent office visits for the tissue expansion process
- Two-stage procedure: tissue expander followed by exchange for permanent implant
- Need to replace implants periodically
Breasts reconstructed with an implant alone will not create a natural droopy appearing breast and may appear fuller in the upper half compared with a natural breast.
Implants are not lifetime devices; both saline and silicone implants can rupture or leak.
If you have saline implants, you will notice a slow deflation of the implant. The body is able to absorb the saline leaking out of the implant and over a few days to a week and you will notice that your implant is getting smaller.
If you have silicone implants, there may be a change in the shape of the implant, however most of the time, there is no change at all.
Implant ruptures rates, regardless of saline or silicone, are approximately 1% per year; this means that your implant can rupture at any time after being placed, but at a very low percentage rate.