Implant-Based Reconstruction

Implant-based reconstruction has various advantages & diasvantages:

  • PROS

    • Short hospital stay (sometimes even same-day discharge)

    • Shorter recovery time compared to tissue reconstruction

    • Selection in size of implant

    • No “donor site” (i.e. relocation of tissue or muscle)

  • CONS

    • Overall less natural look, feel, and movement compared to tissue reconstruction

    • Implants do not ‘age’ (i.e. sag) with other areas of the body

Potential Complications:

  • Possibility of infection requiring removal of implant

  • Possibility of requiring at least one, possibly more, further operations during your lifetime

  • Possibility of implant rupture and/or shifting

  • Palpable edges or rippling of implant

  • Capsular Contraction: when scar tissue forms around the implant, it can cause an alteration in the shape, size, and position of the breast, which may appear firm, and become painful.

One-Stage Implant Reconstruction:

Refers to the immediate placement of an implant at the time of mastectomy.

  • This implant is usually placed behind your Pectoralis Major Muscle (chest muscle).

  • This type of reconstruction is possible if there is sufficient skin remaining after your mastectomy to cover the implant, and this skin has sufficient blood supply.

  • This approach preserves your natural anatomic landmarks, so may be more aesthetically pleasing than delayed reconstruction

  • This option is usually best in patients who have small breasts, and are unlikely to require post-operative radiation.

Two-Stage Implant Reconstruction:

Involves the placement of “tissue expanders” at the time of mastectomy that stretch out the skin and muscle to make room for the placement of an implant at a later date.  

  • At the time of placement, tissue expanders will have some fluid (saline) injected, and approximately 2 weeks following surgery, more fluid will be added through a needle into a port of the tissue expanders. Usually, the expanders are then filled weekly.

  • This process gradually stretches the overlying skin and muscle in order to create a pocket for the future implant.

  • The size of the final implant will be determined by patient preference, and how the skin and muscle respond to the stretch.