Image of some breast implants

Reconstruction Using an Implant Only

My special interest and expertise is in implant based reconstruction. In this operation silicone prosthesis is inserted under the skin and muscle of the chest to replace the volume of breast tissue that has been removed at the time of mastectomy. Sometimes I need to use a piece of Acellular Dermal Matrix (ADM), an artificial tissue (mesh) made from animal skin to keep implant in its position and provide soft cover to the implant. This is quite a simple operation that does not involve cuts elsewhere.

I normally use an expandable implant & adjust its volume by injections of salt water (saline) later which is done in the outpatient weeks after the operation. This will help give the best match for your other breast. Implants will be offered to you if you do not want surgery elsewhere on your body or you are not suitable for reconstruction with your own tissue. This could be due to you not having enough tissue elsewhere or not fit for long operation. This is quickest of all reconstruction operations, quicker recovery and overnight hospital stay only. Operation takes 2-3 hours, healing takes 2-3 weeks and completes recovery 4-6 weeks.

 

Considerations Before Implant Reconstruction

Implant reconstruction does not give much droop (ptosis) so is best for women with relatively small breasts that do not droop at all, or if both breasts are being removed. Many women choosing an implant-only reconstruction will need to have the other breast adjusted to improve the shape and size match. The main disadvantage of implant-based breast reconstruction is that it is impossible to create a breast with an entirely natural shape and feel.

If done on one side, breasts can look a good match whilst dressed but may not look so well matched when undressed. With implant-based reconstruction you may need to have further operations in the future to adjust or exchange the implant. It is my usual practice to offer one session of lipofilling/fat transfer after implant reconstruction to make it look more natural. In this process fat is taken from thigh or stomach (liposuction) and injected under the skin of the reconstructed breast.

Potential problems: Implants are prone to encapsulation (hardening), visible folds and creases, displacement, rupture, and do not give good results if you have to have radiotherapy either before or after the reconstruction is carried out.

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