Breast Implants

1 What is a Breast Reconstruction with Breast Implants ?

Breast reconstruction with breast implants is a surgical procedure that restores the shape to your breast after a mastectomy, which is a surgery done to remove your breasts to prevent breast cancer.

One type of breast reconstruction uses breast implants, silicone devices filled with silicone gel or salt water (saline) to reshape your breasts.

Breast reconstruction with breast implants is a complex procedure performed by a plastic surgeon. The breast reconstruction process can start at the time of your mastectomy, or can be done at a later time. 

The breast reconstruction process is usually composed of two or more operation and several visits to your doctor to insert, position and fill the breast implants.  Breast reconstruction will not create the exact look and feel of your natural breasts.

However, the contour of your new breast may restore a silhouette similar to what you had before the mastectomy.

2 Reasons for Procedure

Here are the most common reasons for breast reconstruction with breast implants procedure.

Breast reconstruction is usually an optional procedure performed to restore shape to your breast following a mastectomy, which is the removal of a breast in order to prevent breast cancer.

3 Potential Risks

Breast reconstruction with a breast implant carries the following potential risks:

  • Implant rupture or deflation.
  • Infection.
  • Bleeding.
  • Changes in breast sensation.
  • Increased risk of future breast surgery to remove or replace the breast implant.
  • Scar tissue that forms and compresses the implant and breast tissue into a hard, unnatural shape (capsular contracture).

In order to correct any of these complications, additional surgery may be necessary. If you need adjuvant radiation therapy, you might not be an ideal candidate for breast implant reconstruction.

Radiation therapy often leaves the skin and underlying tissue discoloured or damaged. In these cases, doctors usually recommend breast reconstruction with a tissue flap instead.

4 Preparing for your Procedure

In preparing for a mastectomy, your doctor may recommend that you meet a plastic surgeon. Consult a plastic surgeon who is board certified and has experience in breast reconstruction following a mastectomy.

Ideally, your breast surgeon and plastic surgeon will work together to develop the best surgical treatment and breast reconstruction strategy in your situation. 

Your plastic surgeon will give a description of your surgical options and may also show you pictures of women who have had various types of breast reconstruction. Your body type, health status and cancer treatment factor into which type of will give the best result.

The plastic surgeon also provides information on the anesthesia, the location of the operation and the necessary follow-up procedures. Your plastic surgeon may recommend surgery on your opposite breast, even if it is healthy.

This is done to match up the shape and size of your reconstructed breast. Before your surgery can be performed, follow your doctor's specific instructions on preparing for the procedure. This may include guidelines on the eating and drinking, adjusting any current medications and quitting smoking.

5 What to Expect

Read on to learn more about what to expect before, during, and after your breast reconstruction with breast implants procedure.

Breast reconstruction begins with placement of a breast implant or tissue expander, either at the time of your mastectomy surgery (immediate reconstruction) or during a later procedure (delayed reconstruction). Breast reconstruction often requires multiple operations, even if you choose immediate reconstruction.

Breast implants. A breast implant is around or teardrop-shaped silicone shell, filled with salt water (saline) or silicone gel. Once restricted because of safety concerns, silicone gel implants are now considered safe.

A plastic surgeon places the implant behind the muscle in your chest (pectoral muscle). Some women are able to have the permanent breast implant placed at the time of the mastectomy.

However, most women require a two-stage process, using a tissue expander before the permanent implant is placed. Tissue expanders Tissue expansion is a process that stretches your remaining chest skin and soft tissues to make room for the breast implant. Your surgeon places a balloon-like tissue expander under your pectoral muscle at the time of your mastectomy.

Over the next few months, through a small valve under your skin, your doctor or nurse uses a needle to inject saline into the valve, filling the balloon in stages. This gradual process allows the skin to stretch over time. You'll go to your doctor every week or two to have the saline injected. You may experience some discomfort or pressure as the implant expands.

After the tissue is adequately expanded, your surgeon performs a second surgery to remove the tissue expander and replace it with a permanent implant. Some tissue expanders are designed to be left in place, so the second operation may be less extensive and require only local anesthesia.

Recovery You may be tired and sore for a few weeks after surgery. Your doctor can prescribe medication to control your pain. You may have drainage tubes for a short time after surgery to remove fluids that collect in the surgical site. The drainage tubes remain in place until the amount of fluid draining substantially decreases. You'll also have stitches (sutures) after your surgery.

They'll probably be absorbable, though, so you won't need to have them removed. Scarring is permanent, but the scars generally fade over time. Getting back to normal activities may take six weeks or longer. Take it easy during this period.

Your doctor will let you know of restrictions to your activities, such as avoiding overhead lifting or strenuous physical activities. Don't be surprised if it seems to take a long time to bounce back from surgery — some women report that it took as long as a year or two before they felt completely healed and back to normal.

Generally, you'll follow up with your plastic surgeon on a yearly basis to monitor your reconstructed breast. Make an appointment sooner than that, however, if you have any concerns about your reconstruction.

Nipple reconstruction Breast reconstruction may also entail reconstruction of your nipple, if you choose, including tattooing to define the dark area of skin surrounding your nipple (areola).

Future breast cancer screening If you've only had one breast reconstructed, you'll need to have screening mammography done regularly on your other breast. Mammography isn't necessary on breasts that have been reconstructed.

You may opt to perform breast self-exams on your natural breast and the skin and surrounding area of your reconstructed breast.

This may help you become familiar with the changes to your breast after surgery so that you can be alert to any new changes and report those to your doctor. Your doctor may recommend that you have magnetic resonance imaging (MRI) done every few years on your reconstructed breast to check for signs of implant rupture.

6 Procedure Results

It is always wise to keep your expectations realistic when anticipating the results of the procedure. Breast reconstruction surgery carries with its many benefits. However, it will not make you look or feel as you did before your mastectomy.

Breast reconstruction can do the following: 

  • Give you a breast contour.
  • Provide improved symmetry to you breast so that they look similar under clothing or bathing suit.
  • Help you avoid the need for an external prosthesis.

Breast reconstruction may do the following:

  • Improve your self-esteem and body image.
  • Partially erase the physical reminders of your disease.
  • Require additional surgery to correct reconstructive problems.

What breast reconstruction will not do: 

  • Make you look as you did before.
  • Give your reconstructed breast the same sensation as your normal one.