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Almost one half of the patients who decide to undergo breast
reconstruction choose the implant procedure. Breast implants are used
for both reconstruction and breast augmentation procedures. The main
advantage of the implant reconstruction is the relative ease of the
operation and rapid recovery. There is no need for surgery on other body
parts which may be required when an autologous method is selected (TRAM,
DIEP Flap). The breast
implants have been shown to be very safe medical devices, however, they
have a limited life expectancy. Patients with an implant reconstruction
may require further procedures in years to come to exchange the implant
or perform other adjustments.
Ideal Candidates:
Ideal candidate should not have any severe medical conditions such
cardiac disease, pulmonary disease, or clotting abnormalities. Implant
reconstruction is less stressful to the body than other methods. In most
cases, if a patient is a good candidate for mastectomy, she will be a
candidate for an implant reconstruction, as well. In contrast to TRAM
and DIEP reconstruction, patients with previous surgical procedures on
the abdomen may have an implant reconstruction. Please review your
previous surgeries with Dr. Soltanian during your consultation. The main
reason to avoid an implant reconstruction is the need for radiation to
the breast area. Radiation therapy renders the skin less suitable for
expansion and coverage of an implant. In rare and exceptional cases, an
implant reconstruction can be attempted after radiation therapy.
Preoperative visit:
During the first visit, pertinent data regarding the cancer history,
cancer treatments, past medical and surgical history are collected.
After the physical examination, Dr. Soltanian will provide you with an
overview of breast reconstruction options for you. He will review
anatomic illustrations, and before and after pictures with you. It is
not uncommon to have more than one consultation before finalizing the
decision for a breast reconstruction procedure. We encourage the
patients to review the information at home and record their questions
for the second preoperative visit. Quite often it is helpful to discuss
the issues with close family members and friends. You will have ample
time to ask your questions and discuss your concerns with Dr. Soltanian.
Upon request, our previous patients are available to share their
experience with you.
Operative Procedure:
An expander will be placed under the chest muscle (pectoralis muscle)
at the time of mastectomy (immediate reconstruction) or at a later point
(delayed reconstruction). The expander is a specialized implant with a
built-in port which allows us to introduce saline into the expander at a
later point. A small plastic tube (drain) is left in the wound.
This will be removed during an office visit.
Depending on the amount of skin available and the laxity of the
tissue, the expander is inflated during subsequent office visits to
reach the desirable size. At a later point, the expander is removed and
a permanent implant is placed into the existing pocket. This is a
separate surgical procedure, however, the patients are discharged to
home on the same day. There is not need for a drain after this
procedure. The recovery from this step is relatively fast.
Recovery
Patients will leave the hospital after 1-2 days after mastectomy. The
drains are removed within 5-7 days after discharge from the hospital.
The level of activity is gradually increased. Within one week from the
surgery, the expansion will begin. It is continued in weekly intervals.
The recovery from the expander exchange is fast. Patients leave the
hospital on the same day. The incision is generally healed within 2
weeks.
Results:
The swelling in the reconstructed breast will gradually subside. This
may take up to 2 months for complete resolution. We allow for complete
healing of the reconstructed breast prior to any “touch-up” or nipple
and areola reconstruction. It may take 3-4 months for the tissue to
regain its natural consistency and feel. Additional procedures will be
scheduled accordingly
(pictures).
All the required procedures are covered by the health insurances,
including matching procedures on the uninvolved breast (''Women's
Health and Cancer Rights Act of 1998'').
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