Breast Reconstruction with Implants
Your surgeon can help you decide whether you are able to have reconstructive surgery and what type is best for you. You will be advised to wait if now is not the best time for you. For instance, you may be advised to wait if you need radiation treatments after surgery.
Breast reconstruction can be done at the same time as the mastectomy procedure. Or it can be delayed until a later time. One kind of reconstruction is the breast implant. A breast implant is a fluid-filled shell inserted during surgery to reform the shape of the breast. Your healthcare provider will talk to you about different kinds of implants, how they work, what's done to check on the implants in the long term, and what you can expect with this surgery.
Inserting a tissue expander
Often the breast area is prepared for a breast implant with a tissue expander. This is an empty implant shell that is inserted during surgery. The tissue expander is slowly filled with fluid or air over several weeks. This is done to stretch the chest skin and muscle to make room for a breast implant.
The tissue expander can be put in through the same cut (incision) as the mastectomy. When the muscle and skin are stretched enough, the expander may be left in place. Or it may be replaced with an implant.
Placing the implant
Most breast implants are shells filled with fluid or gel. To insert the implant, a small incision is made, often through the mastectomy scar. The implant is placed under your chest muscle. Recovery may take 3 to 6 weeks. It may take many months before the bruising and swelling go away and you can see the final results. You may have more surgery later to create a nipple and an areola. Surgery may also be needed to match your remaining breast to the reconstructed one. Expect the reconstructed breast to be firmer than your normal breast.
Risks of breast implant
Any type of surgery has some risk. Some problems related to breast reconstruction with implants include:
Fluid collection in the surgical area (called a seroma)
Anesthesia problems (problems with the medicines used to do the surgery)
Bruising and swelling
The most common problem of breast reconstruction done with implants is called capsular contracture. This is when the scar or capsule around the implant begins to tighten. In some cases, this (and other) problems are severe enough to need a second operation.
Talk with your healthcare provider about what problems to look for and when to call them. Make sure you know what number to call with questions or problems, including after office hours, on weekends, and on holidays.
Women who smoke are at higher risk for problems after surgery. These include slow healing, more noticeable scars, and taking longer to recover. Talk with your healthcare provider and get help quitting before surgery.
February 09, 2018
Gersten, Todd, MD,Stump-Sutliff, Kim, RN, MSN, AOCNS