Implant based breast reconstruction
This is the most commonly performed type of breast reconstruction, particularly for immediate reconstruction. Surgery avoids scars elsewhere on the body and tends to have a shorter recovery time compared to other types reconstruction. It can produce good outcomes giving a natural breast mound. New better shaped implants and the new use of fat injection techniques are improving outcomes further. However, despite these advances it is more difficult to achieve natural droop to the breast with these techniques. This can make it more difficult to match the opposite breast if it has much droop. It usually takes two operations to complete the reconstruction. Implants can have some problems over time, including hardening around the implant and the reconstruction will not ‘age’ with the patient, so making long term symmetry less predictable. Up to a third of patients go on to further surgery in the future. Implants tend to have more problems when radiotherapy has been used and are therefore usually avoided.
Operation in brief
A stretching device is usually placed under the muscle and mastectomy skin. This adds little to the original mastectomy surgery. The stretching device is then inflated with injections over a 2-4 month period. The stretching device is then replaced with a silicone implant. Sometimes an implant can be placed immediately without the need for a stretching device, or a combined stretching device/implant used. Surgery to the opposite breast is performed in some patients to improve symmetry.
Implant Reconstruction facts
Scars
The scar is restricted to the breast and will depend on the type of mastectomy performed. Scars tend to be pink in the first 3-6 months and then fade to white.
Length of surgery and hospital stay
Each operation takes 45-60 minutes. Hospital stay is usually 1-3 nights.
Time off work and recovery
Allow 4-6 weeks depending upon other surgery. People vary in recovery. Patients are mobile after 1-2 days. There is usually discomfort for a few weeks. Moderate exercise is feasible at 4 weeks and strenuous exercise (aerobics) at 8-10 weeks. Driving is usually possible in the second or third week.
Potential complications and limitations
This routine operation is a success for the majority of patients. However, it is very important you understand that occasionally operations can have complications such as bleeding, infection, wound problems or variable scar quality. With implant breast reconstruction additional potential problems include hardening around the implant, rippling or palpability of implants, infection around the implant causing loss of reconstruction in 1-3% cases. Implant reconstruction results do tend to become slightly worse over time resulting in up to a third of patients to seek further surgery after a 10 year period.
